Agustin Michael, Price Lori Lyn, Andoh-Duku Augustine, LaCamera Peter
Department of Pulmonary and Critical Care, St. Elizabeth's Medical Center, Tufts University, Boston, MA, USA.
Guam Regional Medical City, Dededo, GU, USA.
Crit Care Res Pract. 2017;2017:9616545. doi: 10.1155/2017/9616545. Epub 2017 Mar 12.
. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. . We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission). We assessed the impact of EDLOS on hospital mortality, compliance with sepsis protocol, and resuscitation. Statistical significance was determined by chi-square test. . Of the 287 septic ED patients, 137 (47%) were admitted to the ICU in <6 hours. There was no significant in-hospital mortality difference between early and delayed admissions ( = 0.68). Both groups have similar compliance with the 3-hour protocol ( = 0.77). There was no significant difference in achieving optimal resuscitation within 12 hours ( = 0.35). . We found that clinical outcomes were not significantly different between early and delayed ICU admissions. Additionally, EDLOS did not impact compliance with the sepsis protocol with the exception of repeat lactate draw.
急诊科住院时间（EDLOS）对脓毒症治疗结果的影响尚需阐明。我们试图更好地了解脓毒症患者的EDLOS与治疗结果及方案依从性之间的关系。我们对2012年1月至2015年12月期间在一家三级护理教学医院从急诊科收治入重症监护病房（ICU）的脓毒症患者进行了一项回顾性观察研究。纳入了287例严重脓毒症和脓毒性休克患者。研究人群分为EDLOS＜6小时（早期入院）和≥6小时（延迟入院）的患者。我们评估了EDLOS对医院死亡率、脓毒症方案依从性及复苏情况的影响。采用卡方检验确定统计学意义。在287例脓毒症急诊科患者中，137例（47%）在＜6小时内被收治入ICU。早期和延迟入院患者的院内死亡率无显著差异（P = 0.68）。两组对3小时方案的依从性相似（P = 0.77）。在12小时内实现最佳复苏的情况无显著差异（P = 0.35）。我们发现，早期和延迟入住ICU患者的临床结果无显著差异。此外，除了重复乳酸检测外，EDLOS并未影响脓毒症方案的依从性。
