Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department
Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department
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DOI：
10.1097/ccm.0b013e3181cc4824
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发表时间：
2010-04-01
影响因子：
8.8
通讯作者：
Goyal, Munish
中科院分区：
文献类型：
--
作者：
Gaieski, David F.;Mikkelsen, Mark E.;Goyal, Munish
目的：为了研究在急诊科开始早期目标导向治疗的严重脓毒症或脓毒性休克患者的抗生素给药时间与生存率之间的关系，设计：单中心队列研究。设置：2005年至2006年的一个学术三级护理中心的急诊科。患者：261例接受早期目标导向治疗的患者。干预措施：无。测量和主要结果：不同的时间截止从分流到抗生素管理，资格早期目标导向治疗抗生素管理，分流到适当的抗生素管理，资格早期目标导向治疗适当的抗生素管理对住院死亡率的影响进行了检查。261例患者的平均年龄为59 ± 16岁; 41%为女性。住院死亡率为31%。从分诊到使用抗生素的中位时间为119分钟（四分位距，76-192分钟），从资格鉴定到使用抗生素的中位时间为42分钟（四分位距，0-93分钟）。在不同的小时截止值下评估时，从分诊时间或从早期目标导向治疗资格到抗生素使用时间与死亡率之间没有显著相关性。当分析从分诊到使用适当抗生素的时间时，
Objective: To study the association between time to antibiotic administration and survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department.Design: Single-center cohort study.Setting: The emergency department of an academic tertiary care center from 2005 through 2006.Patients: Two hundred sixty-one patients undergoing early goal-directed therapy.Interventions: None.Measurements and Main Results: Effects of different time cutoffs from triage to antibiotic administration, qualification for early goal-directed therapy to antibiotic administration, triage to appropriate antibiotic administration, and qualification for early goal-directed therapy to appropriate antibiotic administration on in-hospital mortality were examined. The mean age of the 261 patients was 59 +/- 16 yrs; 41% were female. In-hospital mortality was 31%. Median time from triage to antibiotics was 119 mins (interquartile range, 76-192 mins) and from qualification to antibiotics was 42 mins (interquartile range, 0-93 mins). There was no significant association between time from triage or time from qualification for early goal-directed therapy to antibiotics and mortality when assessed at different hourly cutoffs. When analyzed for time from triage to appropriate antibiotics, there was a significant association at the