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Assessment of Health Care Exposures and Outcomes in Adult Patients With Sepsis and Septic Shock
Author(s) -
Katherine Fay,
Mathew R. P. Sapiano,
Runa H. Gokhale,
Raymund Dantes,
Nicola D. Thompson,
David Katz,
Susan M. Ray,
Lucy E. Wilson,
Rebecca Perlmutter,
Joelle Nadle,
Deborah Godine,
Linda Frank,
Geoff Brousseau,
Helen Johnston,
Wendy Bamberg,
Ghinwa Dumyati,
Deborah Nelson,
Ruth Lynfield,
Malini B. DeSilva,
Marion Kainer,
Alexia Zhang,
Valerie Ocampo,
Monika Samper,
Rebecca Pierce,
Lourdes Irizarry,
Marla Sievers,
Meghan Maloney,
Anthony E. Fiore,
Shelley S. Magill,
Lauren Epstein
Publication year - 2020
Publication title -
jama network open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.278
H-Index - 39
ISSN - 2574-3805
DOI - 10.1001/jamanetworkopen.2020.6004
Subject(s) - medicine , sepsis , septic shock , interquartile range , epidemiology , retrospective cohort study , incidence (geometry) , emergency medicine , population , medical record , health care , intensive care medicine , environmental health , physics , optics , economics , economic growth
Key Points Question What types of health care exposures occur during the 30 days before hospitalization of a patient with sepsis or septic shock, and how common are these exposures? Findings In this cohort study of 1078 US adults with sepsis and septic shock across 10 states, most patients experienced sepsis onset outside of the hospital, had recent encounters with the health care system, and had a sepsis-associated pathogen documented; 42% of patients received antimicrobial drugs, chemotherapy, wound care, dialysis, or surgery in the 30 days before sepsis occurred. After controlling for other factors, an association was found between underlying comorbidities, such as cirrhosis, immunosuppression, and vascular disease, and 30-day mortality. Meaning The findings suggest that future efforts to improve outcomes among patients with sepsis and septic shock would benefit from examination of health maintenance practices and recent health care exposures as potential opportunities among high-risk patients.

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