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J Korean Soc Emerg Med > Volume 19(4); 2008 > Article
Journal of The Korean Society of Emergency Medicine 2008;19(4): 398-404.
The Factors Affect that Survival of Sepsis or Septic Shock Patients Admitted through Emergency Department
Jae Min Byun, Han Jin Cho, Hoon Pyo Hong, Han Sung Choi, Young Gwan Ko
Department of Emergency Medicine, College of Medicine, Kyung Hee University, Seoul, Korea. chohj327@hotmail.com
We sought to determine the impact of the factors that affect the mortality of critically ill patients with sepsis or septic shock.
We performed a retrospective cohort study of adult patients admitted with sepsis or septic shock from April 1, 2006, to December 31, 2007, at a single, urban academic emergency department (ED). The primary outcome was patients' death. Predictor variables were the EDLOS, the time from registration to order for antibiotics administration, number of hospital days, initial systolic blood pressure, systolic blood pressure after hydration, heart rate, respiration rate, body temperature, serum white blood cell count, and serum lactic acid level. Cox's proportional hazard model was used to elucidate the relationship of predictor variables to patients' death. Data were analyzed with SPSS version 12.0.
The overall mortality rate was 56.2%. Average length of stay was 204.5+/-90.6 minutes in the survival group and 166.6+/-81.8 minutes in the death group (p=0.041). The mortality was not shown to be significantly different between patients spending less than 4 hours and patients spending over 4 hours. The relative risk (RR) for patients' death was significantly higher in patients with hypotension persisting despite adequate fluid resuscitation.
EDLOS did not affect mortality for the patients admitted with sepsis or septic shock. The patients' prognoses were mainly related to the systolic blood pressure after hydration.
Key words: Length of stay, Sepsis, Mortality, Severity
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