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10.1097/CCM.0000000000002264

http://scihub22266oqcxt.onion/10.1097/CCM.0000000000002264
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C6065262!6065262!28234754
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suck abstract from ncbi


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pmid28234754      Crit+Care+Med 2017 ; 45 (5): 759-65
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  • Delays From First Medical Contact to Antibiotic Administration for Sepsis #MMPMID28234754
  • Seymour CW; Kahn JM; Martin-Gill C; Callaway CW; Yealy DM; Scales D; Angus DC
  • Crit Care Med 2017[May]; 45 (5): 759-65 PMID28234754show ga
  • Objective: To evaluate the association between total medical contact, prehospital, and emergency department delays in antibiotic administration and in-hospital mortality among patient encounters with community-acquired sepsis. Design: Retrospective cohort study. Setting: Nine hospitals served by 21 emergency medical services agencies in southwestern Pennsylvania from 2010 through 2012. Patients: All emergency medical services encounters with community acquired sepsis transported to the hospital. Measurements and Main Results: Among 58,934 prehospital encounters, 2,683 had community-acquired sepsis, with an inhospital mortality of 11%. Median time from first medical contact to antibiotic administration (total medical contact delay) was 4.2 hours (interquartile range, 2.7?8.0 hr), divided into a median pre-hospital delay of 0.52 hours (interquartile range, 0.40?0.66 hr) and a median emergency department delay of 3.6 hours (inter-quartile range, 2.1?7.5 hr). In a multivariable analysis controlling for other risk factors, total medical contact delay was associated with increased in-hospital mortality (adjusted odds ratio for death, 1.03 [95% CI, 1.00?1.05] per 1-hr delay; p < 0.01), as was emergency department delay (p = 0.04) but not prehospital delay (p = 0.61). Conclusions: Both total medical contact and emergency department delay in antibiotic administration are associated with inhospital mortality in community-acquired sepsis.
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