Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study.
- Author:
Min Gyun KIM
1
;
Tae Gun SHIN
;
Ik Joon JO
;
Won Young KIM
;
Seung Mok RYOO
;
Sung Phil CHUNG
;
Jin Ho BEOM
;
Sung Hyuk CHOI
;
Kyuseok KIM
;
You Hwan JO
;
Gu Hyun KANG
;
Gil Joon SUH
;
Jonghwan SHIN
;
Tae Ho LIM
;
Kap Su HAN
;
Sung Yeon HWANG
Author Information
1. Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sygood.hwang@samsung.com
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Sepsis;
Septic shock;
Mortality;
Interhospital transfer
- MeSH:
Emergencies*;
Emergency Service, Hospital*;
Hospital Mortality;
Humans;
Logistic Models;
Mortality;
Observational Study*;
Odds Ratio;
Prognosis;
Prospective Studies;
Renal Replacement Therapy;
Retrospective Studies*;
Sepsis;
Shock;
Shock, Septic*;
Tertiary Care Centers*;
Ventilators, Mechanical
- From:Journal of the Korean Society of Emergency Medicine
2018;29(5):465-473
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. METHODS: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. RESULTS: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4–9 vs. 6; IQR, 4–8; P < 0.001). Mechanical ventilator (29% vs. 21%, P < 0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78–1.28; P=0.999) for the transferred group compared with the non-transferred group. CONCLUSION: The transferred group showed higher severity and needed more organ support procedures than the nontransferred group. However, inter-hospital transfer did not affect in-hospital mortality.
