Mortality of severe septic patients between physician's high and low care volumes
Background: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. Methods: We analyzed the data from a t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-08-01
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| Series: | Biomedical Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2319417016300750 |
| _version_ | 1817992880158932992 |
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| author | Chun-Yao Lin Jo-Chi Tseng Chih-Yu Huang Chien-Ming Chu Huang-Pin Wu |
| author_facet | Chun-Yao Lin Jo-Chi Tseng Chih-Yu Huang Chien-Ming Chu Huang-Pin Wu |
| author_sort | Chun-Yao Lin |
| collection | DOAJ |
| description | Background: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear.
Methods: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis.
Results: Clinical data of total 484 patients with severe sepsis were recorded. Cox regression model showed that physician's care volume was an independent factor for lowering mortality in ICU patients with severe sepsis (hazard ratio 0.708; 95% confidence interval 0.514–0.974; p = 0.034). Patients treated by high care volume physician had four out of nine bundle therapies that were significantly higher in percentage following the SSC guidelines. These four therapies were renal replacement therapy, administration of low-dose steroids for septic shock, prophylaxis of gastro-intestinal bleeding, and control of hyperglycemia.
Conclusion: High care volume physician may decrease mortality in ICU patients with severe sepsis through fitting bundle therapies for sepsis. |
| first_indexed | 2024-04-14T01:32:02Z |
| format | Article |
| id | doaj.art-7fd58dc3c9e047bebd945bf7e5824557 |
| institution | Directory Open Access Journal |
| issn | 2319-4170 |
| language | English |
| last_indexed | 2024-04-14T01:32:02Z |
| publishDate | 2017-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Biomedical Journal |
| spelling | doaj.art-7fd58dc3c9e047bebd945bf7e58245572022-12-22T02:20:08ZengElsevierBiomedical Journal2319-41702017-08-0140422623110.1016/j.bj.2017.06.005Mortality of severe septic patients between physician's high and low care volumesChun-Yao Lin0Jo-Chi Tseng1Chih-Yu Huang2Chien-Ming Chu3Huang-Pin Wu4Division of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanDivision of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanDivision of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanDivision of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanDivision of Pulmonary, Critical Care and Sleep Medicine, Chang Gung Memorial Hospital, Keelung, TaiwanBackground: Patients with severe sepsis frequently require intensive care unit (ICU) admission and different ICU care models may influence their outcomes. The mortality of severe septic patients between physician's high and low care volume remains unclear. Methods: We analyzed the data from a three-year prospective observation study, which was performed in an adult medical ICU of Chung Gung Memorial Hospital, Keelung. The data included initial bundle therapies based on the Surviving Sepsis Campaign (SSC) guidelines for patients with severe sepsis. Results: Clinical data of total 484 patients with severe sepsis were recorded. Cox regression model showed that physician's care volume was an independent factor for lowering mortality in ICU patients with severe sepsis (hazard ratio 0.708; 95% confidence interval 0.514–0.974; p = 0.034). Patients treated by high care volume physician had four out of nine bundle therapies that were significantly higher in percentage following the SSC guidelines. These four therapies were renal replacement therapy, administration of low-dose steroids for septic shock, prophylaxis of gastro-intestinal bleeding, and control of hyperglycemia. Conclusion: High care volume physician may decrease mortality in ICU patients with severe sepsis through fitting bundle therapies for sepsis.http://www.sciencedirect.com/science/article/pii/S2319417016300750MortalitySevere sepsisIntensive care unitPhysician's care volume |
| spellingShingle | Chun-Yao Lin Jo-Chi Tseng Chih-Yu Huang Chien-Ming Chu Huang-Pin Wu Mortality of severe septic patients between physician's high and low care volumes Biomedical Journal Mortality Severe sepsis Intensive care unit Physician's care volume |
| title | Mortality of severe septic patients between physician's high and low care volumes |
| title_full | Mortality of severe septic patients between physician's high and low care volumes |
| title_fullStr | Mortality of severe septic patients between physician's high and low care volumes |
| title_full_unstemmed | Mortality of severe septic patients between physician's high and low care volumes |
| title_short | Mortality of severe septic patients between physician's high and low care volumes |
| title_sort | mortality of severe septic patients between physician s high and low care volumes |
| topic | Mortality Severe sepsis Intensive care unit Physician's care volume |
| url | http://www.sciencedirect.com/science/article/pii/S2319417016300750 |
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