Old subjects with sepsis in the emergency department: trend analysis of case fatality rate
<h3>Background</h3><p dir="ltr">The burden of sepsis represents a global health care problem. We aimed to assess the case fatality rate (CFR) and its predictors in subjects with sepsis admitted to a general Italian hospital from 2009 to 2016, stratified by risk score.<...
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2019
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| _version_ | 1864513513987244032 |
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| author | Andrea Fabbri (356760) |
| author2 | Giulio Marchesini (314275) Barbara Benazzi (8177634) Alice Morelli (8177637) Danilo Montesi (8177640) Cesare Bini (8177643) Stefano Giovanni Rizzo (18615112) |
| author2_role | author author author author author author |
| author_facet | Andrea Fabbri (356760) Giulio Marchesini (314275) Barbara Benazzi (8177634) Alice Morelli (8177637) Danilo Montesi (8177640) Cesare Bini (8177643) Stefano Giovanni Rizzo (18615112) |
| author_role | author |
| dc.creator.none.fl_str_mv | Andrea Fabbri (356760) Giulio Marchesini (314275) Barbara Benazzi (8177634) Alice Morelli (8177637) Danilo Montesi (8177640) Cesare Bini (8177643) Stefano Giovanni Rizzo (18615112) |
| dc.date.none.fl_str_mv | 2019-12-23T03:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1186/s12877-019-1384-8 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Old_subjects_with_sepsis_in_the_emergency_department_trend_analysis_of_case_fatality_rate/25907230 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Health sciences Epidemiology Sepsis Elderly Case fatality rate Risk score Trend Emergency department |
| dc.title.none.fl_str_mv | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">The burden of sepsis represents a global health care problem. We aimed to assess the case fatality rate (CFR) and its predictors in subjects with sepsis admitted to a general Italian hospital from 2009 to 2016, stratified by risk score.</p><h3>Methods</h3><p dir="ltr">We performed a retrospective analysis of all sepsis-related hospitalizations after Emergency Department (ED) visit in a public Italian hospital in an 8-year period. A risk score to predict CFR was computed by logistic regression analysis of selected variables in a training set (2009–2012), and then confirmed in the whole study population. A trend analysis of CFR during the study period was performed dividing patient as high-risk (upper tertile of risk score) or low-risk.</p><h3>Results</h3><p dir="ltr">Two thousand four hundred ninety-two subjects were included. Over time the incidental admission rate (no. of sepsis-related admissions per 100 total admissions) increased from 4.1% (2009–2010) to 5.4% (2015–2016); P < 0.001, accompanied by a reduced CFR (from 38.0 to 18.4%; P < 0.001). A group of 10 variables (admission to intensive care unit, cardio-vascular dysfunction, HIV infection, diabetes, age ≥ 80 years, respiratory diseases, number of organ dysfunction, digestive diseases, dementia and cancer) were selected by the logistic model to predict CFR with good accuracy: AUC 0.873 [0.009]. Along the years CFR decreased from 31.8% (2009–2010) to 25.0% (2015–2016); P = 0.007. The relative proportion of subjects ≥80 years (overall, 52.9% of cases) and classified as high-risk did not change along the years. CFR decreased only in low-risk subjects (from 13.3 to 5.2%; P < 0.001), and particularly in those aged ≥80 (from 18.2 to 6.6%; P = 0.003), but not in high-risk individuals (from 69.9 to 64.2%; P = 0.713).</p><h3>Conclusion</h3><p dir="ltr">Between 2009 and 2016 the incidence of sepsis-related hospitalization increased in a general Italian hospital, with a downward trend in CFR, only limited to low-risk patients and particularly to subjects ≥80 years.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Geriatrics<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12877-019-1384-8" target="_blank">https://dx.doi.org/10.1186/s12877-019-1384-8</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_caf1bee25aa3484a3d10d38036b93fba |
| identifier_str_mv | 10.1186/s12877-019-1384-8 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/25907230 |
| publishDate | 2019 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Old subjects with sepsis in the emergency department: trend analysis of case fatality rateAndrea Fabbri (356760)Giulio Marchesini (314275)Barbara Benazzi (8177634)Alice Morelli (8177637)Danilo Montesi (8177640)Cesare Bini (8177643)Stefano Giovanni Rizzo (18615112)Health sciencesEpidemiologySepsisElderlyCase fatality rateRisk scoreTrendEmergency department<h3>Background</h3><p dir="ltr">The burden of sepsis represents a global health care problem. We aimed to assess the case fatality rate (CFR) and its predictors in subjects with sepsis admitted to a general Italian hospital from 2009 to 2016, stratified by risk score.</p><h3>Methods</h3><p dir="ltr">We performed a retrospective analysis of all sepsis-related hospitalizations after Emergency Department (ED) visit in a public Italian hospital in an 8-year period. A risk score to predict CFR was computed by logistic regression analysis of selected variables in a training set (2009–2012), and then confirmed in the whole study population. A trend analysis of CFR during the study period was performed dividing patient as high-risk (upper tertile of risk score) or low-risk.</p><h3>Results</h3><p dir="ltr">Two thousand four hundred ninety-two subjects were included. Over time the incidental admission rate (no. of sepsis-related admissions per 100 total admissions) increased from 4.1% (2009–2010) to 5.4% (2015–2016); P < 0.001, accompanied by a reduced CFR (from 38.0 to 18.4%; P < 0.001). A group of 10 variables (admission to intensive care unit, cardio-vascular dysfunction, HIV infection, diabetes, age ≥ 80 years, respiratory diseases, number of organ dysfunction, digestive diseases, dementia and cancer) were selected by the logistic model to predict CFR with good accuracy: AUC 0.873 [0.009]. Along the years CFR decreased from 31.8% (2009–2010) to 25.0% (2015–2016); P = 0.007. The relative proportion of subjects ≥80 years (overall, 52.9% of cases) and classified as high-risk did not change along the years. CFR decreased only in low-risk subjects (from 13.3 to 5.2%; P < 0.001), and particularly in those aged ≥80 (from 18.2 to 6.6%; P = 0.003), but not in high-risk individuals (from 69.9 to 64.2%; P = 0.713).</p><h3>Conclusion</h3><p dir="ltr">Between 2009 and 2016 the incidence of sepsis-related hospitalization increased in a general Italian hospital, with a downward trend in CFR, only limited to low-risk patients and particularly to subjects ≥80 years.</p><h2>Other Information</h2><p dir="ltr">Published in: BMC Geriatrics<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1186/s12877-019-1384-8" target="_blank">https://dx.doi.org/10.1186/s12877-019-1384-8</a></p>2019-12-23T03:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1186/s12877-019-1384-8https://figshare.com/articles/journal_contribution/Old_subjects_with_sepsis_in_the_emergency_department_trend_analysis_of_case_fatality_rate/25907230CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/259072302019-12-23T03:00:00Z |
| spellingShingle | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate Andrea Fabbri (356760) Health sciences Epidemiology Sepsis Elderly Case fatality rate Risk score Trend Emergency department |
| status_str | publishedVersion |
| title | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| title_full | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| title_fullStr | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| title_full_unstemmed | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| title_short | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| title_sort | Old subjects with sepsis in the emergency department: trend analysis of case fatality rate |
| topic | Health sciences Epidemiology Sepsis Elderly Case fatality rate Risk score Trend Emergency department |