Triage and flow management in sepsis

Autor: Hudson Henrique Gomes Pires, Fábio Fernandes Neves, Antonio Pazin-Filho
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: International Journal of Emergency Medicine, Vol 12, Iss 1, Pp 1-8 (2019)
Druh dokumentu: article
ISSN: 1865-1372
1865-1380
DOI: 10.1186/s12245-019-0252-9
Popis: Abstract Background Sepsis is a major public health problem, with a growing incidence and mortality rates still close to 30% in severe cases. The speed and adequacy of the treatment administered in the first hours of sepsis, particularly access to intensive care, are important to reduce mortality. This study compared the triage strategies and intensive care rationing between septic patients and patients with other indications of intensive care. This study included all patients with signs for intensive care, enrolled in the intensive care management system of a Brazilian tertiary public emergency hospital, from January 1, 2010, to December 31, 2016. The intensivist periodically evaluated the requests, prioritizing them according to a semi-quantitative scale. Demographic data, Charlson Comorbidity Index (CCI), Sequential Organ Failure Assessment (SOFA), and quick SOFA (qSOFA), as well as surgical interventions, were used as possible confounding factors in the construction of incremental logistic regression models for prioritization and admission to intensive care outcomes. Results The study analyzed 9195 ICU requests; septic patients accounted for 1076 cases (11.7%), 293 (27.2%) of which were regarded as priority 1. Priority 1 septic patients were more frequently hospitalized in the ICU than nonseptic patients (52.2% vs. 34.9%, p
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