Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock
Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock
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DOI：
10.1097/01.ccm.0000217961.75225.e9
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发表时间：
2006-06-01
影响因子：
8.8
通讯作者：
Cheang, Mary
中科院分区：
文献类型：
--
作者：
Kumar, Arland;Roberts, Daniel;Cheang, Mary
目的：确定感染性休克复发性/持续性低血压首次发作后延迟开始有效抗菌治疗的患病率及其对死亡率的影响。设计，1989年7月至2004年6月进行的X回顾性队列研究。背景：加拿大和美国的14个重症监护病房（4个内科，4个外科，6个内科/外科混合病房）和10家医院（4个学术医院，6个社区医院）。患者2，731例感染性休克成人患者的医疗记录。无。测量和主要结果。主要的结局指标是出院时的存活率，在2,154例感染性休克患者中，（78.9%）仅在复发性或持续性低血压发作后接受有效抗菌治疗的患者中，有效抗菌治疗开始延迟与住院死亡率之间存在强相关性（校正比值比1.119 [每小时延迟]，95%置信区间1.103-1.136，p
Objective: To determine the prevalence and impact on mortality of delays in initiation of effective antimicrobial therapy from initial onset of recurrent/persistent hypotension of septic shock.Design., X retrospective cohort study performed between July 1989 and June 2004.Setting: Fourteen intensive care units (four medical, four surgical, six mixed medical/surgical) and ten hospitals (four academic, six community) in Canada and the United States. Patients. Medical records of 2,731 adult patients with septic shock.Interventions. None.Measurements and Main Results. The main outcome measure was survival to hospital discharge, Among the 2,154 septic shock patients (78.9% total) who received effective antimicrobial therapy only after the onset of recurrent or persistent hypotension, a strong relationship between the delay in effective antimicrobial initiation and in-hospital mortality was noted (adjusted odds ratio 1.119 [per hour delay], 95% confidence interval 1.103-1.136, p