Research Activities, September 2011: Emergency Medicine: Patients with sepsis fare better when admitted via the emergency department rather than directly to the hospital

Research Activities, September 2011: Emergency Medicine: Patients with sepsis fare better when admitted via the emergency department rather than directly to the hospital: Emergency Medicine
Patients with sepsis fare better when admitted via the emergency department rather than directly to the hospital

Sepsis, a potentially life-threatening condition that requires immediate medical attention, occurs when the body's overwhelming immune response to infection triggers widespread inflammation that can lead to dropped blood pressure and shock. A new study finds that patients with sepsis who are admitted through emergency departments (EDs) may have a better chance of survival than patients who are directly admitted to the hospital.

Emilie Powell, M.D., M.B.A., Rahul K. Khare, M.D., and Northwestern University colleagues analyzed data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality. They found a 17 percent lower likelihood of dying from sepsis when a patient was admitted through the ED than when a patient was directly admitted to the hospital. This lower mortality rate could be a result of EDs having more staff; better technology, such as central venous pressure monitors; and readily available antibiotics. The combination of these elements is crucial for providing patients with sepsis the recommended treatment of aggressive resuscitation within 6 hours, which is time- and resource-intensive.

The authors state that this study demonstrates the valuable role that the often-overcrowded ED plays in providing sepsis care and early resuscitation. Given the more favorable mortality rates in the ED, patients with sepsis should be brought there first for resuscitation instead of admitted to a hospital floor. This study was funded in part by the Agency for Healthcare Research and Quality (T32 HS00078).

See "Lower mortality in sepsis patients admitted through the ED vs direct admission," by Dr. Powell, Dr. Khare, D. Mark Courtney, M.D., and Joe Feinglass, Ph.D., in the February 2011 American Journal of Emergency Medicine [Epub ahead of print].

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