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Infections and severe sepsis in solid-organ transplant patients admitted from a university-based ED.
- Stephen Trzeciak, Randall Sharer, Derek Piper, Therese Chan, Chad Kessler, R Phillip Dellinger, and Kenneth J Pursell.
- Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USA. TRZECIAK-STEPHEN@cooperhealth.edu
- Am J Emerg Med. 2004 Nov 1; 22 (7): 530-3.
AbstractThe objective was to provide a descriptive analysis of infectious processes in transplant patients admitted from the emergency department (ED). A database of all adult transplant patients at a university medical center was cross-referenced with a computerized record of all ED visits over an 18-month period. ED charts, inpatient records, and microbiology data were retrospectively reviewed. Final diagnoses and outcomes were analyzed. There were 352 ED visits by transplant patients (kidney 66%, kidney/pancreas 15%, liver 13%, lung 3%, heart 3%). Infections were the most common indications for admission (77/217, 35%). Urinary tract infection and pneumonia were the most common infections. Nine of 77 patients (11.7%) with documented infections developed severe sepsis, which was the most common reason for ICU utilization. Thirty-five percent of transplant patients admitted from the ED had acute infections, and 11.7% of these patients had severe sepsis. The emergency physician must have a high index of suspicion for infections when evaluating organ transplant recipients.
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