Breaking News
January 23, 2019 - Short interval between last meal of the day and bedtime may not affect blood glucose levels
January 23, 2019 - Still Too Many Highway Deaths Tied to Speeding
January 23, 2019 - Prenatal valproate exposure linked to increased ADHD risk
January 23, 2019 - Compound identified that may help treat heart failure
January 23, 2019 - Undiagnosed Asthma in Urban Adolescents May Be Common
January 23, 2019 - Study describes metabolism of intestinal microbiota in babies for the first time
January 22, 2019 - Study links concussions to development of epilepsy
January 22, 2019 - Specialist-led hospital bereavement service may help restrain legal action after difficult deaths
January 22, 2019 - Genetic study reveals possible new routes to treating osteoarthritis
January 22, 2019 - Blood test may detect early signs of lung-transplant rejection
January 22, 2019 - Blood marker could aid in early prediction of Alzheimer’s progression
January 22, 2019 - Orthodontic treatment does not guarantee future dental health
January 22, 2019 - Rutgers researchers discover cause of bone loss in people with joint replacements
January 22, 2019 - Diversity among rural Africans extends to their gut microbiomes
January 22, 2019 - Newly developed biological system lets cells to create self-curving cornea
January 22, 2019 - VTv Therapeutics Announces Publication of Comprehensive Data in Science Translational Medicine Detailing the Discovery and Clinical Development of TTP399, including Results of Phase 2 AGATA Study
January 22, 2019 - about one in three adults with prediabetes has arthritis
January 22, 2019 - A look at how data is democratizing health care
January 22, 2019 - Alcohol-Linked Disease Overtakes Hep C As Top Reason For Liver Transplant
January 22, 2019 - Researchers identify new genes linked with age-related macular degeneration
January 22, 2019 - MPFI researchers identify synaptic logic for connections between two brain hemispheres
January 22, 2019 - New study extends our knowledge of the link between miRNAs and cancer
January 22, 2019 - Asthma, eczema are not barriers to active lifestyle in teenagers
January 22, 2019 - Genetic changes may predict likelihood of relapse in breast cancer patients
January 22, 2019 - Antiepileptic drug use by people with Alzheimer’s disease linked to accumulation of hospital days
January 22, 2019 - IUPUI researcher receives $2.85 million grant to find ways to improve bone strength
January 22, 2019 - Precision medicine can help keep astronauts healthy during deep space missions
January 22, 2019 - Detecting signs of neurodegeneration earlier and more accurately
January 22, 2019 - Mouse studies challenge ‘inhibition’ theory of autism
January 22, 2019 - SSB launches BIOSTAT RM TX single-use bioreactor for producing consistent quality cellular products
January 22, 2019 - Experimental drug can positively modify key characteristic behavior in FXS patients
January 22, 2019 - Low-Income Women Lack Menstrual Hygiene Supplies
January 22, 2019 - Better mouse model built to enable precision-medicine research for Alzheimer’s
January 22, 2019 - Molecular profiling of precancerous lung lesions could lead to early detection and new treatments
January 22, 2019 - Genetic factors influence where fat is stored in our bodies
January 22, 2019 - The Psychology Behind Sticking to Your New Year’s Resolutions
January 22, 2019 - Scientists aim to find genetic causes of developmental abnormalities in the vagina and uterus
January 22, 2019 - New survey reveals scale of preventative healthcare challenge in the UK
January 22, 2019 - Looming Global Crisis Means People’s Diets Must Change: Experts
January 22, 2019 - Excessive social media use is comparable to drug addiction
January 22, 2019 - Researchers show how mechanical stress affects bone development
January 22, 2019 - Study takes a step closer to understanding the body’s response to opioid painkillers
January 22, 2019 - Unexpected connection found between feeding and memory centers of the brain
January 22, 2019 - A revolutionary approach transforms bone trauma treatment
January 22, 2019 - Early studies and recent clinical trials on nerve growth factor
January 22, 2019 - Dry Mouth and Older Adults: Information for Caregivers
January 22, 2019 - Are your grandparents getting tipsy at the holiday party?
January 22, 2019 - New machine learning algorithms identify early symptoms of urinary tract infections
January 22, 2019 - Young women skipping the Pap smear test due to embarrassment
January 22, 2019 - A global influenza pandemic high on the WHO’s agenda
January 22, 2019 - Amgen Makes All Repatha (evolocumab) Device Options Available In The US At A 60 Percent Reduced List Price
January 22, 2019 - Elastronics—hydrogel-based microelectronics for localized low-voltage neuromodulation
January 22, 2019 - Branched-chain amino acids in tumors can be targeted to prevent and treat cancer
January 22, 2019 - Fueling macrophages with energy to attack and eat cancer cells
January 22, 2019 - Amgen And UCB Receive Positive Vote From FDA Advisory Committee In Favor Of Approval For Evenity (romosozumab)
January 22, 2019 - Does being bilingual make children more focused? Study says no
January 22, 2019 - Study reveals new genes and biological pathways linked to osteoarthritis
January 22, 2019 - FSU study provides better understanding of spinal cord injuries
January 22, 2019 - Delaying bath for newborn babies increases breastfeeding rates, finds study
January 21, 2019 - WHO identifies non-communicable diseases as major threat to human health
January 21, 2019 - Many parents still try non-evidence-based cold prevention methods for children
January 21, 2019 - High Levels of Activity, Motor Ability Linked to Better Cognition
January 21, 2019 - Killer blows? Knockout study of pair of mouse MicroRNA provides cancer insight
January 21, 2019 - Buffalo researchers receive grant to quicken development of generic equivalents of contraceptives
January 21, 2019 - One-third of pregnant women do not believe cannabis is harmful to their fetus
January 21, 2019 - Fiderstat could be used as chemopreventative drug for intestinal cancers caused by APC gene mutations
January 21, 2019 - Modifying healthcare delivery practices may improve discussions between youth and healthcare providers
January 21, 2019 - UNIST researcher named as recipient of Merck’s 2018 Life Science Awards
January 21, 2019 - How Getting a Flu Shot Could Save Your Life
January 21, 2019 - Surgical adhesions can be treated, prevented in mice
January 21, 2019 - Increased physician-targeted marketing associated with higher opioid overdose deaths
January 21, 2019 - Researchers uncover specific microbial signatures of intestinal disease
January 21, 2019 - Researchers discover new blood vessel system in bones
January 21, 2019 - Simple blood test reliably detects signs of Alzheimer’s damage before symptoms
January 21, 2019 - Study to investigate new targeted oral treatments for severe asthma
January 21, 2019 - Plan Your Plate | NIH News in Health
January 21, 2019 - Fecal occult blood test may improve CRC outcomes in some
January 21, 2019 - Blood test detects Alzheimer’s disease years before symptoms develop
January 21, 2019 - Mount Sinai joins with Paradigm and ReqMed to repurpose drug for treatment of MPS
January 21, 2019 - FDA Advisory Committee Votes on Zynquista (sotagliflozin) as Treatment for Adults with Type 1 Diabetes
Sepsis patients treated and released from ED for outpatient follow-up experience good outcomes

Sepsis patients treated and released from ED for outpatient follow-up experience good outcomes

image_pdfDownload PDFimage_print

National guidelines assume that all patients who’re diagnosed with clinical sepsis in an emergency department will be admitted to the hospital for additional care, but new research has found that many more patients are being treated and released from the ED for outpatient follow-up than previously recognized.

Despite the finding that about 16 percent of sepsis patients who are diagnosed in the emergency department are not being admitted to the hospital, but are treated in the ED and released for outpatient management, researchers at Intermountain Medical Center in Salt Lake City found that these patients are still experiencing good outcomes.

“We found that many more emergency department patients with sepsis are discharged from the ED than previously recognized, but by and large these patients had fairly good outcomes,” said principal investigator Ithan Peltan, MD, MSc, a pulmonary and critical care medicine specialist and researcher from Intermountain Medical Center in Salt Lake City, which is part of the Intermountain Healthcare system.

Researchers presented results from the study of nearly 16,000 sepsis patients this week at the American Thoracic Society’s annual international conference in San Diego.

Sepsis is a life-threatening response to an infection. It occurs when chemicals released into the bloodstream to fight an infection trigger inflammatory responses throughout the body, which can trigger a cascade of changes that can damage multiple organ systems and cause them to fail. Without timely treatment, sepsis can rapidly cause tissue damage, organ failure, and death.

“Sepsis is a common and deadly problem among patients who come to the emergency department,” said Dr. Peltan. “While widely-accepted guidelines assume all sepsis patients will be admitted to the hospital, we found that about 16 percent are in fact discharged from the ED for outpatient management. Our research looked at sepsis patients who were discharged and investigated their outcomes.”

The sepsis disease process isn’t fully understood, and treatment is often complicated, which is one of the reasons guidelines have assumed sepsis patients need to be admitted to the hospital. However, the Intermountain Healthcare research suggests that physicians can identify a subset of sepsis patients who do well with outpatient management.

“Outpatient management of sepsis is likely not automatically ‘wrong.’ But wide variation in care provided by different physicians suggests there’s room to identify criteria and develop and test tools clinicians can use to guide and optimize sepsis triage decisions,” said Dr. Peltan.

For the study, researchers searched Intermountain Healthcare’s Enterprise Data Warehouse, which is one of the nation’s largest depositories of clinical data, at two referral hospitals and two community hospitals in Utah between July 2013 and January 2017.

Researchers identified 15,832 adult ED patients who met clinical sepsis criteria. After excluding repeat ED visits, trauma patients, patients who left the ED against medical advice or on hospice, or those who passed away in the ED, 12,002 of 13,419 eligible ED sepsis patients were included in the analysis. Patients who transferred to another acute care facility were considered to be admitted, whereas transfers to non-acute care in skilled nursing or psychiatric facilities were classified as discharges.

Unsurprisingly, patients who were discharged were much less ill than admitted patients. However, after accounting for illness severity and other factors, Dr. Peltan and his team found that discharged sepsis patients had about the same chance of dying in the following 30 days as admitted patients. Some ED physicians admitted all, or almost all, of the patients they treated, while others discharged up to 39% of their sepsis patients.

Additionally, the researchers found that 65% of sepsis patients who were treated and released from the ED were women, compared to 35% of the male patients who were admitted to the hospital. Researchers plan more to examine this and other potential disparities more closely in their next study. An initial hypothesis is that women may come to the ED earlier in their illness, meaning they’re less sick.

“Physicians seem to do a good job of knowing who can be discharged,” said Dr. Peltan. “However, there was quite a bit of variation between physicians regarding how many of their patients get discharged, which suggests it may be important to give clinicians guidance to ensure patients who need it are admitted to the hospital, and to identify patients who can be considered for outpatient management and potentially avoid the inconvenience, expense, and risks of hospitalization.”

Source:

https://intermountainhealthcare.org/news/2018/05/sepsis-patients-treated-released-emergency-departments-outpatient-follow-up/

Tagged with:

About author

Related Articles