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Critical Care: Sepsis Diagnosis and Resuscitation |

Predictors of Progression to Septic Shock in Patients Meeting Clinical Criteria for Severe Sepsis

Bristol Whiles, BS; Amanda Deis, BS; Steven Simpson, MD
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University of Kansas School of Medicine, Kansas City, KS


Copyright 2016, American College of Chest Physicians. All Rights Reserved.


Chest. 2016;150(4_S):351A. doi:10.1016/j.chest.2016.08.364
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SESSION TITLE: Sepsis Diagnosis and Resuscitation

SESSION TYPE: Original Investigation Slide

PRESENTED ON: Tuesday, October 25, 2016 at 11:00 AM - 12:15 PM

PURPOSE: To determine identifiable risk factors associated with increased risk of progression of severe sepsis to septic shock.

METHODS: We developed a retrospective cohort study of severe sepsis patients ≥18 years of age admitted through the University of Kansas Hospital emergency department (ED) between 3/1/2007 - 9/30/2015. Severe sepsis was identified by an ICD-9 diagnosis code (995.92) or by clinical criteria with acute organ dysfunction at ≥2 organ sites. Inclusion criteria also required a diagnosed infection, antibiotic administration within 24 hours of ED triage, and recorded length of hospital stay and discharge disposition. The presence of septic shock on presentation at our facility was defined as any of the following within 3 hours of ED triage: 1) systolic blood pressure >90mmHg, 2) mean arterial pressure <65, or 3) vasopressor administration. Since we were interested in the progression of severe sepsis to septic shock, patients with shock on presentation were removed from our study. Progression to septic shock was defined as administration of a vasopressor subsequently during the same hospitalization. Chi-squared, t-test, and multivariate regression modeling was used to determine variables predictive of progression from severe sepsis to septic shock.

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