The DISPARITY-II Study: Delays to Antibiotic Administration in Women With Severe Sepsis or Septic Shock
The DISPARITY-II Study: Delays to Antibiotic Administration in Women With Severe Sepsis or Septic Shock
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DOI：
10.1111/acem.12546
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发表时间：
2014-12-01
影响因子：
4.4
通讯作者：
Napoli, Anthony M.
中科院分区：
文献类型：
--
作者：
Madsen, Tracy E.;Napoli, Anthony M.
BackgroundEarly antibiotics reduce mortality in patients with severe sepsis and septic shock. Recent work demonstrated that women experience greater delays to antibiotic administration, but it is unknown if this relationship remains after adjusting for factors such as source of infection.ObjectivesThe objective was to investigate whether gender and/or source of infection are associated with delays to antibiotics in patients with severe sepsis or septic shock.MethodsThis was a retrospective, observational study in an urban academic emergency department and national Surviving Sepsis Campaign (SSC) database study site. Consecutive patients age 18years and older admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to March 2012 were included. Two trained research assistants, blinded to the primary outcome, used a standardized abstraction form to obtain patient demographic and clinical data, including the Sequential Organ Failure Assessment (SOFA) scores and comorbidities. Time to first antibiotic and presumed source of infection were extracted from the SSC database. Univariate analyses were performed with Pearson chi-square tests and t-tests. Linear regression was performed with time to first antibiotic as the primary outcome. Covariates, chosen a priori by study authors, included age, race, ethnicity, source of infection, SOFA score, and lactate.ResultsA total of 771 patients were included. Women were 45.3% of the sample, the mean age was 66years (95% confidence interval [CI]=65.1 to 67.5years), 19.4% were nonwhite, and 8% were Hispanic. Mean time to first antibiotic was 153minutes (95% CI=143 to 163minutes) for men and 184minutes (95% CI=171 to 197minutes) for women (p
