Dataset Information

Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit.

ABSTRACT:

Objectives

Timely recognition and treatment of sepsis is essential to reduce mortality and morbidity. Acutely ill patients often consult a general practitioner (GP) as the first healthcare provider. During out-of-hours, GP cooperatives deliver this care in the Netherlands. The aim of this study is to explore the role of these GP cooperatives in the care for patients with sepsis.

Design

Retrospective study of patient records from both the hospital and the GP cooperative.

Setting

An intensive care unit (ICU) of a general hospital in the Netherlands, and the colocated GP cooperative serving 260 000 inhabitants.

Participants

We used data from 263 patients who were admitted to the ICU due to community-acquired sepsis between January 2011 and December 2015.

Main outcome measures

Contact with the GP cooperative within 72?hours prior to hospital admission, type of contact, delay from the contact until hospital arrival, GP diagnosis, initial vital signs and laboratory values, and hospital mortality.

Results

Of 263 patients admitted to the ICU, 127 (48.3%) had prior GP cooperative contacts. These contacts concerned home visits (59.1%), clinic consultations (18.1%), direct ambulance deployment (12.6%) or telephone advice (10.2%). Patients assessed by a GP were referred in 64% after the first contact. The median delay to hospital arrival was 1.7?hours. The GP had not suspected an infection in 43% of the patients. In this group, the in-hospital mortality rate was significantly higher compared with patients with suspected infections (41.9% vs 17.6%). Mortality difference remained significant after correction for confounders.

Conclusion

GP cooperatives play an important role in prehospital management of sepsis and recognition of sepsis in this setting proved difficult. Efforts to improve management of sepsis in out-of-hours primary care should not be limited to patients with a suspected infection, but also include severely ill patients without clear signs of infection.

SUBMITTER: Loots FJ

PROVIDER: S-EPMC6144400 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Publications

Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit.

Loots Feike J FJ Smits Marleen M van Steensel Carlijn C Giesen Paul P Hopstaken Rogier M RM van Zanten Arthur R H ARH

BMJ open 20180917 9

<h4>Objectives</h4>Timely recognition and treatment of sepsis is essential to reduce mortality and morbidity. Acutely ill patients often consult a general practitioner (GP) as the first healthcare provider. During out-of-hours, GP cooperatives deliver this care in the Netherlands. The aim of this study is to explore the role of these GP cooperatives in the care for patients with sepsis.<h4>Design</h4>Retrospective study of patient records from both the hospital and the GP cooperative.<h4>Setting ...[more]

PMID: 30224394

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Dataset Information

Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit.

Objectives

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Management of sepsis in out-of-hours primary care: a retrospective study of patients admitted to the intensive care unit.

Similar Datasets

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