AI Article Synopsis
- The study aimed to analyze the types of sepsis in ICU patients and how delayed antibiotic treatment affects their recovery.
- The research utilized the MIMIC-IV database, focusing on the time lapse between recognizing sepsis and administering antibiotics, while identifying four distinct sepsis phenotypes based on organ dysfunction.
- Results showed that delaying antibiotics increased the risk of death within 28 days, particularly in patients with respiratory and cardiovascular issues.
Article Abstract
Purpose: To identify phenotypes of Intensive Care Unit (ICU) onset sepsis and its associated harms of delayed time-to-antibiotics.
Materials And Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV) database was employed to identify patients with ICU onset sepsis. The primary exposure was time-to-antibiotics, as measured from sepsis recognition to first antibiotic administered. Latent profile analysis (LPA) was used to identify phenotypes of sepsis based on individual organ failure score derived from Sequential Organ Failure Assessment (SOFA). Interactions between phenotypes and time-to-antibiotics on 28-day mortality were explored.
Results: 6246 patients were enrolled in final analysis. The overall 28-day mortality was 12.7%. Delayed time-to-antibiotics was associated with increased 28-day mortality in patients with ICU onset sepsis (HR 1.12, 95% CI 1.08-1.18). Four phenotypes of sepsis were identified: phenotype 1 was characterized by respiratory dysfunction, phenotype 2 was characterized by cardiovascular dysfunction, phenotype 3 was characterized by multiple organ dysfunction, and phenotype 4 was characterized by neurological dysfunction. The adjusted HR of 28-day mortality was 1.16 (95% CI 1.08-1.25) in phenotype 1, and 1.06 (95% CI 1.00-1.13) in phenotype 2, while no significant interaction was observed.
Conclusions: Septic patients with respiratory or cardiovascular dysfunction were associated with harms of delayed time-to-antibiotics.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jcrc.2022.154221 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
PDA-associated infective endocarditis with pulmonary artery perforation.
Pak J Med Sci
January 2025
Muhammad Ali Mumtaz, MD FACS. Tahir Heart Institute, Fazl-e-Omar Hospital, Chenab Nagar, District Chiniot, Pakistan.
Infective endocarditis used to frequently cause mortality in subjects having PDA before the advent of antibiotics and surgical ligation. It has been documented that clinically silent PDAs may cause infective complications of heart valves. We present case of an 18-years-old male who presented with palpitations and fever to our emergency department.
View Article and Find Full Text PDFEtiology of Hospital-Acquired Pneumonia (HAP) and Ventilator-Associated Pneumonia (VAP) in Tertiary-Care Hospitals in Thailand: A Multicenter, Retrospective Cohort Study.
Infect Drug Resist
January 2025
Infectious Diseases Unit, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
Purpose: To describe the top three causative organisms of hospital acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) in Thailand.
Patients And Methods: This multi-center retrospective cohort study included HAP/VAP patients hospitalized in 2019 in three university-affiliated hospitals and a private hospital in Bangkok, Thailand. Medical records of patients with a documented diagnosis of nosocomial pneumonia (NP) were systematically reviewed to collect data on demographic, clinical, microbiological, and 30-day readmission due to NP.
Multidisciplinary Approaches and Molecular Diagnostics in New-Onset Refractory Status Epilepticus and Nontuberculous Mycobacterial CNS Infections in the ICU: A Case Report.
Cureus
December 2024
Medical Emergency Unit, Unidade Local de Saúde de São José, Lisbon, PRT.
The diagnosis and management of complex neurological conditions such as New-Onset Refractory Status Epilepticus (NORSE) and central nervous system (CNS) infections caused by non-tuberculous mycobacteria (NTM) pose substantial difficulties in intensive care units (ICUs). This article combines a case report and a literature review that explores the diagnostic dilemmas and therapeutic strategies for these critical conditions. We report the case of an 83-year-old female with chronic granulomatous meningitis secondary to NTM, presenting a challenging diagnostic and complex management complexity typical of such a rare disease through a period time of five years.
View Article and Find Full Text PDFClinical Features of COVID-19 Associated Pulmonary Aspergillosis: A Multicenter, Retrospective Study.
Clin Respir J
January 2025
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Objective: This study was conducted to further understand the clinical characteristics of COVID-19 associated pulmonary aspergillosis (CAPA).
Methods: In this study, we conducted a multicenter retrospective survey, which included patients with COVID-19 from five hospitals in Zhejiang, China. A total of 197 patients with COVID-19 were included in the study.
What's the bug?: An unusual cause of bacterial meningitis in a patient with history of transsphenoidal surgery.
Am J Emerg Med
January 2025
Department of Emergency Medicine, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States of America. Electronic address:
Bacterial meningitis is an increasingly rare disease that carries significant morbidity and mortality. We describe the case of a 38-year-old male with a past medical history of pituitary macroadenoma with prior endonasal surgeries on prednisone therapy daily for resultant hypopituitarism and juvenile myoclonic epilepsy on lamotrigine daily who was transferred to an academic tertiary emergency department due to concern for developing pituitary apoplexy. At the outside emergency department, the patient presented complaining of sudden onset severe headache.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!