Document Detail


Sepsis in general surgery: the 2005-2007 national surgical quality improvement program perspective.
MedLine Citation:
PMID:  20644134     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To document the incidence, mortality rate, and risk factors for sepsis and septic shock compared with pulmonary embolism and myocardial infarction in the general-surgery population. DESIGN: Retrospective review. SETTING: American College of Surgeons National Surgical Quality Improvement Program institutions. PATIENTS: General-surgery patients in the 2005-2007 National Surgical Quality Improvement Program data set. MAIN OUTCOME MEASURES: Incidence, mortality rate, and risk factors for sepsis and septic shock. RESULTS: Of 363 897 general-surgery patients, sepsis occurred in 8350 (2.3%), septic shock in 5977 (1.6%), pulmonary embolism in 1078 (0.3%), and myocardial infarction in 615 (0.2%). Thirty-day mortality rates for each of the groups were as follows: 5.4% for sepsis, 33.7% for septic shock, 9.1% for pulmonary embolism, and 32.0% for myocardial infarction. The septic-shock group had a greater percentage of patients older than 60 years (no sepsis, 40.2%; sepsis, 51.7%; and septic shock, 70.3%; P < .001). The need for emergency surgery resulted in more cases of sepsis (4.5%) and septic shock (4.9%) than did elective surgery (sepsis, 2.0%; septic shock, 1.2%) (P < .001). The presence of any comorbidity increased the risk of sepsis and septic shock 6-fold (odds ratio, 5.8; 95% confidence interval, 5.5-6.2) and increased the 30-day mortality rate 22-fold (odds ratio, 21.8; 95% confidence interval, 17.6-26.9). CONCLUSIONS: The incidences of sepsis and septic shock exceed those of pulmonary embolism and myocardial infarction. The risk factors for mortality include age older than 60 years, the need for emergency surgery, and the presence of any comorbidity. This study emphasizes the need for early recognition of patients at risk via aggressive screening and the rapid implementation of evidence-based guidelines.
Authors:
Laura J Moore; Frederick A Moore; S Rob Todd; Stephen L Jones; Krista L Turner; Barbara L Bass
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  145     ISSN:  1538-3644     ISO Abbreviation:  Arch Surg     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-20     Completed Date:  2010-08-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  695-700     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, The Methodist Hospital, Weill Cornell Medical College, 6550 Fannin Street, Houston, TX 77030, USA. ljmoore@tmhs.org
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Colectomy / adverse effects
Confidence Intervals
Digestive System Surgical Procedures / adverse effects
Female
General Surgery / statistics & numerical data*
Humans
Incidence
Intestine, Small / surgery
Male
Middle Aged
Mortality / trends
Myocardial Infarction / epidemiology,  etiology
Odds Ratio
Pancreatectomy / adverse effects
Program Evaluation
Pulmonary Embolism / epidemiology,  etiology
Quality Indicators, Health Care
Quality of Health Care*
Retrospective Studies
Sepsis / epidemiology*,  etiology*,  mortality
Shock, Septic / epidemiology,  etiology
Surgical Procedures, Operative / adverse effects*
United States
Vascular Surgical Procedures / adverse effects
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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