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住院脓毒症、严重脓毒症或脓毒性休克患者并报告青霉素过敏的结局:一项回顾性队列研究。

Outcomes in hospitalised patients with sepsis, severe sepsis or septic shock and reported penicillin allergy: a retrospective cohort study.

机构信息

Internal Medicine, Allina Health, Minneapolis, Minnesota, USA.

Internal Medicine, Allina Health, Minneapolis, Minnesota, USA

出版信息

BMJ Open. 2022 Feb 23;12(2):e050879. doi: 10.1136/bmjopen-2021-050879.

Abstract

OBJECTIVE

To determine outcomes in hospitalised patients with sepsis and reported penicillin allergy (PcnA).

DESIGN

Observational retrospective cohort study using data from electronic health records.

SETTING

A large single health system with 11 hospitals of small, medium and large sizes including a 630-bed tertiary care teaching hospital.

PARTICIPANTS

Patients (n=5238) ≥18 years of age, hospitalised with sepsis, severe sepsis or septic shock between 1 January 2016 and 31 December 2018, received antibacterial agents, and had documented PcnA status. Patients <18 years of age at admission were excluded.

OUTCOME MEASURES

Primary outcomes evaluated were inpatient mortality and 30-day mortality posthospital discharge. Secondary outcomes were hospital length of stay, 30-day readmissions, duration of antibiotic use, rate of infection and total cost of care.

RESULTS

There was no difference in outcomes including inpatient or 30-day mortality, hospital length of stay, in-hospital antibiotic duration, infection, total cost of care and 30-day readmission rate between patients labelled with a PcnA vs patients who did not report PcnA (non-PcnA).

CONCLUSION

In this retrospective single health system study, there was no difference in key outcomes including inpatient or 30-day mortality in patients admitted with sepsis and reported PcnA compared with patients who reported no PcnA.

摘要

目的

确定报告有青霉素过敏(PcnA)的住院脓毒症患者的结局。

设计

使用电子病历数据进行回顾性观察性队列研究。

设置

一个拥有 11 家大小不一的医院的大型单一医疗系统,包括一家拥有 630 张床位的三级保健教学医院。

参与者

18 岁以上,2016 年 1 月 1 日至 2018 年 12 月 31 日期间因脓毒症、严重脓毒症或脓毒性休克住院,接受抗菌药物治疗,且有记录的青霉素过敏状态的患者。入院时年龄<18 岁的患者被排除在外。

主要结局

评估的主要结局为住院期间死亡率和出院后 30 天死亡率。次要结局为住院时间、30 天再入院率、抗生素使用时间、感染率和总治疗费用。

结果

在住院或 30 天死亡率、住院时间、住院期间抗生素使用时间、感染率、总治疗费用和 30 天再入院率等结局方面,标记有 PcnA 的患者与未报告 PcnA 的患者(非 PcnA)之间无差异。

结论

在这项回顾性单一医疗系统研究中,与未报告青霉素过敏的患者相比,报告有青霉素过敏的住院脓毒症患者的关键结局,包括住院或 30 天死亡率方面无差异。

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