TY - JOUR
T1 - Predictors of intensive care unit transfer or death in emergency department patients with suspected infection
AU - Pedersen, Marie Kristine Jessen
AU - Mackenhauer, Julie
AU - Hvass, Anne Mette S W
AU - Heide-Jørgensen, Uffe
AU - Christiansen, Christian Fynbo
AU - Kirkegaard, Hans
PY - 2015
Y1 - 2015
N2 - OBJECTIVES: The aim of this study was to identify predictors of ICU transfer or death within 48 h obtainable within 4 h of admission in emergency department (ED) patients with suspected infection.PATIENTS AND METHODS: This was a nested case-control study based on a prospective cohort of adult patients admitted to the ED at Aarhus University Hospital, in 2011, who had a blood culture drawn upon admission. Cases met the composite endpoint of ICU transfer or death within 4-48 h of admission. We identified up to three controls for each case, matched by age and admission month. We collected data on possible predictors from medical records. Univariate and multivariate logistic regressions were performed to identify predictors.RESULTS: A total of 1578 patients had a blood culture drawn in the ED. Among these, 61 (4%) patients were transferred to an ICU and 15 (1%) patients died within 4-48 h of admission. We could obtain complete data on 59 cases, which were matched to 165 controls. Significant predictors of ICU transfer or death within 4-48 h included temperature as a continuous variable, and neurologic (altered mental status), respiratory, and cardiovascular dysfunction.CONCLUSION: Readily available clinical and laboratory variables at arrival in the ED can support identification of late deterioration leading to ICU transfer or death within 48 h of admission.
AB - OBJECTIVES: The aim of this study was to identify predictors of ICU transfer or death within 48 h obtainable within 4 h of admission in emergency department (ED) patients with suspected infection.PATIENTS AND METHODS: This was a nested case-control study based on a prospective cohort of adult patients admitted to the ED at Aarhus University Hospital, in 2011, who had a blood culture drawn upon admission. Cases met the composite endpoint of ICU transfer or death within 4-48 h of admission. We identified up to three controls for each case, matched by age and admission month. We collected data on possible predictors from medical records. Univariate and multivariate logistic regressions were performed to identify predictors.RESULTS: A total of 1578 patients had a blood culture drawn in the ED. Among these, 61 (4%) patients were transferred to an ICU and 15 (1%) patients died within 4-48 h of admission. We could obtain complete data on 59 cases, which were matched to 165 controls. Significant predictors of ICU transfer or death within 4-48 h included temperature as a continuous variable, and neurologic (altered mental status), respiratory, and cardiovascular dysfunction.CONCLUSION: Readily available clinical and laboratory variables at arrival in the ED can support identification of late deterioration leading to ICU transfer or death within 48 h of admission.
U2 - 10.1097/MEJ.0000000000000200
DO - 10.1097/MEJ.0000000000000200
M3 - Journal article
C2 - 25144399
SN - 0969-9546
VL - 22
SP - 176
EP - 180
JO - European Journal of Emergency Medicine
JF - European Journal of Emergency Medicine
IS - 3
ER -