Articles: sepsis.
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Am. J. Respir. Crit. Care Med. · Apr 2024
Observational StudyHeterogeneity of Benefit from Earlier Time-to-Antibiotics for Sepsis.
Rationale: Shorter time-to-antibiotics improves survival from sepsis, particularly among patients in shock. There may be other subgroups for whom faster antibiotics are particularly beneficial. Objectives: Identify patient characteristics associated with greater benefit from shorter time-to-antibiotics. ⋯ Spline analysis confirmed differential nonlinear associations of time-to-antibiotics with mortality in patients with metastatic cancer and shock. Conclusions: In patients with community-onset sepsis, the mortality benefit of shorter time-to-antibiotics varied by patient characteristics. These findings suggest that shorter time-to-antibiotics for sepsis is particularly important among patients with cancer and/or shock.
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The prognostic evaluation of the septic patient has recently been enriched by some predictive indices such as albumin concentration, lactate/albumin ratio (LAR) and C-reactive protein/albumin ratio (CAR). The performance of these indices has been evaluated in septic patients in intensive care, but until now their performance in infected patients in the Emergency Department (ED) has not been evaluated. ⋯ All three indices had a good discriminatory ability for the risk of short-term death in patients with infection, indicating their promising use in the ED as well as in the ICU. Further studies are needed to confirm the better performance of albumin compared to LAR and CAR.
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Multicenter Study Observational Study
Long-term risk of death in patients with infection attended by prehospital emergency services.
To develop and validate a risk model for 1-year mortality based on variables available from early prehospital emergency attendance of patients with infection. ⋯ The model showed excellent ability to predict 1-year mortality based on epidemiological, analytical, and clinical variables, identifying patients at high risk of death soon after their first contact with the health care system.
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Observational Study
Combining biomarkers of BNIP3 L, S100B, NSE and accessible measures to prediction sepsis-associated encephalopathy: a prospective observational study.
Accurate identification of delirium in sepsis patients is crucial for guiding clinical diagnosis and treatment. However, there are no accurate biomarkers and indicators at present. We aimed to identify which combinations of cognitive impairment-related biomarkers and other easily accessible assessments best predict delirium in sepsis patients. ⋯ The logistic regression showed that the combination model was strongly correlated with cognitive dysfunction in sepsis patients.
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To estimate preoperative risk of postoperative infections using structured electronic health record (EHR) data. ⋯ Parsimonious preoperative models for predicting postoperative infection risk using EHR data were developed and showed comparable performance to existing American College of Surgeons National Surgical Quality Improvement Program risk models that use manual chart review. These models can be used to estimate risk-adjusted postoperative infection rates applied to large volumes of EHR data in a timely manner.