National estimates of severe sepsis in United States emergency departments
National estimates of severe sepsis in United States emergency departments
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DOI：
10.1097/01.ccm.0000277043.85378.c1
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发表时间：
2007-08-01
影响因子：
8.8
通讯作者：
Yealy, Donald M.
中科院分区：
文献类型：
--
作者：
Wang, Henry E.;Shapiro, Nathan I.;Yealy, Donald M.
目的：急诊科（艾德）是发现和治疗疑似严重脓毒症患者的第一站。然而，在艾德严重脓毒症的国家流行病学和分布的评价很少存在。我们试图确定国家估计的数量，时间，艾德住院时间，并提出了怀疑严重sepus.Design的艾德患者的病例分布：2001-2004年艾德数据的分析，从全国医院门诊医疗调查。成人（年龄，≥ 18岁）疑似严重脓毒症患者，定义为同时存在感染（艾德国际疾病分类，第9次修订，ICD-9）感染诊断，或分诊温度= 100.4华氏度）和器官功能障碍（艾德ICD-9）诊断为器官功能障碍、插管或在急诊科分诊收缩压6小时。在疑似严重脓毒症患者中，20.6%的患者接受低容量艾德治疗（：520，000年访问），15.6%提交给非大都市统计区的艾德，53.5%提交给没有医学院附属机构的ED。超过一半的到达救护车。结论：可疑的严重脓毒症患者占每年超过50万艾德访问，与个人的专利平均花费近5小时的ED。这些国家的数据提供了关键的全系统的信息，设计和实施战略，严重脓毒症治疗。
Objective: The emergency department (ED) often serves as the first site for the recognition and treatment of patients with suspected severe sepsis. However, few evaluations of the national epidemiology and distribution of severe sepsis in the ED exist. We sought to determine national estimates of the number, timing, ED length of stay, and case distribution of patients presenting to the ED with suspected severe sepsis.Design: Analysis of 2001-2004 ED data from the National Hospital Ambulatory Medical Care Survey.Setting: National multistage probability sample of United States ED data.Patients: Adult (age, >= 18 yrs) patients with suspected severe sepsis, defined as the concurrent presence of an infection (ED International Classification of Diseases, 9th Revision, ICD-9) diagnosis of infection, or a triage temperature = 100.4 degrees F) and organ dysfunction (ED ICD-9) diagnosis of organ dysfunction, intubation, or a triage systolic blood pressure 6 hrs in the ED. Of suspected severe sepsis patients, 20.6% presented to a low-volume ED (:520,000 annual visits), 15.6% presented to ED in non-Metropolitan Statistical Areas, and 53.5% presented to EDs without medical school affiliations. More than half arrived by ambulance.Conclusions: Suspected severe sepsis patients account for more than 500,000 ED visits annually, with individual patents spending an average of almost 5 hrs in the ED. These national data offer key systemwide information for designing and implementing strategies for severe sepsis treatment.