Physician variation in time to antimicrobial treatment for septic patients presenting to the emergency department

Critical Care Medicine

Volumn 45, Issue 6, 2017, Pages 1011-1018

  Peltan, Ithan D ^a,b,c   Mitchell, Kristina H ^c   Rudd, Kristina E ^c   Mann, Blake A ^c   Carlbom, David J ^c   Hough, Catherine L ^c   Rea, Thomas D ^c   Brown, Samuel M ^a,b  

^a INTERMOUNTAIN MEDICAL CENTER   (United States)

^b UNIVERSITY OF UTAH SCHOOL OF MEDICINE   (United States)

^c UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE   (United States)

Author keywords

Antimicrobial timing; Door to antibiotic time; Physician variation; Sepsis; Septic shock

Indexed keywords

ANTIBIOTIC AGENT; ANTIINFECTIVE AGENT;

ADULT; APACHE; ARTICLE; CHARLSON COMORBIDITY INDEX; COHORT ANALYSIS; CONTROLLED STUDY; DISEASE SEVERITY; EMERGENCY WARD; FEMALE; FOLLOW UP; HUMAN; HYPOTENSION; LENGTH OF STAY; LONG TERM CARE; MAJOR CLINICAL STUDY; MALE; MIDDLE AGED; PHYSICIAN; PNEUMONIA; PRIORITY JOURNAL; RETROSPECTIVE STUDY; SEPSIS; SEPTIC SHOCK; TIME TO TREATMENT; AGE; AGED; BLOOD PRESSURE; CLINICAL PRACTICE; HOSPITAL EMERGENCY SERVICE; HOSPITAL MORTALITY; MORTALITY; SEVERITY OF ILLNESS INDEX; SHOCK, SEPTIC; STATISTICS AND NUMERICAL DATA; TIME FACTOR; UNIVERSITY HOSPITAL;

ACADEMIC MEDICAL CENTERS; ADULT; AGE FACTORS; AGED; ANTI-INFECTIVE AGENTS; BLOOD PRESSURE; EMERGENCY SERVICE, HOSPITAL; FEMALE; HOSPITAL MORTALITY; HUMANS; MALE; MIDDLE AGED; PRACTICE PATTERNS, PHYSICIANS'; RETROSPECTIVE STUDIES; SEPSIS; SEVERITY OF ILLNESS INDEX; SHOCK, SEPTIC; TIME FACTORS; TIME-TO-TREATMENT;

EID: 85020487047     PISSN: 00903493     EISSN: 15300293     Source Type: Journal    
DOI: 10.1097/CCM.0000000000002436     Document Type: Article

References (45)

1. Singer M, Deutschman CS, Seymour CW, et al: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA 2016; 315:801-810
2. Angus DC, Linde-Zwirble WT, Lidicker J, et al: Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001; 29:1303-1310
3. Seymour CW, Rea TD, Kahn JM, et al: Severe sepsis in pre-hospital emergency care: Analysis of incidence, care, and outcome. Am J Respir Crit Care Med 2012; 186:1264-1271
4. Gaieski DF, Edwards JM, Kallan MJ, et al: Benchmarking the incidence and mortality of severe sepsis in the United States. Crit Care Med 2013; 41:1167-1174
5. Lagu T, Rothberg MB, Shieh MS, et al: Hospitalizations, costs, and outcomes of severe sepsis in the United States 2003 to 2007. Crit Care Med 2012; 40:754-761
6. Kaukonen KM, Bailey M, Suzuki S, et al: Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. JAMA 2014; 311:1308-1316
7. Kumar A, Roberts D, Wood KE, et al: Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med 2006; 34:1589-1596
8. Gaieski DF, Mikkelsen ME, Band RA, et al: Impact of time to antibiotics on survival in patients with severe sepsis or septic shock in whom early goal-directed therapy was initiated in the emergency department. Crit Care Med 2010; 38:1045-1053
9. Rivers E, Nguyen B, Havstad S, et al; Early Goal-Directed Therapy Collaborative Group: Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 2001; 345:1368-1377
10. ProCESS Investigators; Yealy DM, Kellum JA, Huang DT, et al: A randomized trial of protocol-based care for early septic shock. New Engl J Med 2014; 370:1683-1693
11. ARISE Investigators, ANZICS Clinical Trials Group; Peake SL, Delaney A, Bailey M, et al: Goal-directed resuscitation for patients with early septic shock. New Engl J Med 2014; 371:1496-1506
12. Dellinger RP, Levy MM, Rhodes A, et al; Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup: Surviving sepsis campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 2013; 41:580-637
13. Waterer GW, Kessler LA, Wunderink RG: Delayed administration of antibiotics and atypical presentation in community-acquired pneumonia. Chest 2006; 130:11-15
14. Talan DA, Zibulewsky J: Relationship of clinical presentation to time to antibiotics for the emergency department management of suspected bacterial meningitis. Ann Emerg Med 1993; 22:1733-1738
15. Amaral AC, Fowler RA, Pinto R, et al; Cooperative Antimicrobial Therapy of Septic Shock Database Research Group: Patient and organizational factors associated with delays in antimicrobial therapy for septic shock. Crit Care Med 2016; 44:2145-2153
16. Cullen M, Fogg T, Delaney A: Timing of appropriate antibiotics in patients with septic shock: A retrospective cohort study. Emerg Med Australas 2013; 25:308-315
17. Madsen TE, Napoli AM: The DISPARITY-II study: Delays to antibiotic administration in women with severe sepsis or septic shock. Acad Emerg Med 2014; 21:1499-1502
18. Band RA, Gaieski DF, Hylton JH, et al: Arriving by emergency medical services improves time to treatment endpoints for patients with severe sepsis or septic shock. Acad Emerg Med 2011; 18:934-940
19. Studnek JR, Artho MR, Garner CL, et al.: The impact of emergency medical services on the ED care of severe sepsis. Am J Emerg Med 2012; 30:51-56
20. Pines JM, Morton MJ, Datner EM, et al: Systematic delays in antibiotic administration in the emergency department for adult patients admitted with pneumonia. Acad Emerg Med 2006; 13:939-945
21. Cartmill RS, Walker JM, Blosky MA, et al: Impact of electronic order management on the timeliness of antibiotic administration in critical care patients. Int J Med Inform 2012; 81:782-791
22. Fee C, Weber EJ, Maak CA, et al: Effect of emergency department crowding on time to antibiotics in patients admitted with communityacquired pneumonia. Ann Emerg Med 2007; 50:501-9, 509.e1
23. Sri-On J, Chang Y, Curley DP, et al: Boarding is associated with higher rates of medication delays and adverse events but fewer laboratory-related delays. Am J Emerg Med 2014; 32:1033-1036
24. Mikkelsen ME, Gaieski DF, Goyal M, et al.: Factors associated with nonadherence to early goal-directed therapy in the ED. Chest 2010; 138:551-558
25. Djurkovic S, Baracaldo JC, Guerra JA, et al: A survey of clinicians addressing the approach to the management of severe sepsis and septic shock in the United States. J Crit Care 2010; 25:658. e1-658.e6
26. Quan H, Sundararajan V, Halfon P, et al: Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005; 43:1130-1139
27. Knaus WA, Draper EA, Wagner DP, et al: APACHE II: A severity of disease classification system. Crit Care Med 1985; 13:818-829
28. Landis JR, Koch GG: The measurement of observer agreement for categorical data. Biometrics 1977; 33:159-174
29. Furnival GM, Wilson RW: Regressions by leaps and bounds. Technometrics 1974; 16:499-511
30. Peduzzi P, Concato J, Kemper E, et al: A simulation study of the number of events per variable in logistic regression analysis. J Clin Epidemiol 1996; 49:1373-1379
31. Akaike H: Information theory and an extension of the maximum likelihood principle. In: Selected Papers of Hirotugu Akaike. Parzen E, Tanabe K, Kitagawa G (Eds). New York, Springer, 1998, pp 199-213
32. Hosmer DW, Lemeshow S: Applied Logistic Regression. New York, Wiley, 1989.
33. Wennberg JE: Time to tackle unwarranted variations in practice. BMJ 2011; 342:d1513-d1513
34. Kahn JM, Angus DC: Reducing the cost of critical care: New challenges, new solutions. Am J Respir Crit Care Med 2006; 174:1167-1168
35. Puskarich MA, Trzeciak S, Shapiro NI, et al; Emergency Medicine Shock Research Network (EMSHOCKNET): Association between timing of antibiotic administration and mortality from septic shock in patients treated with a quantitative resuscitation protocol. Crit Care Med 2011; 39:2066-2071
36. Ferrer R, Martin-Loeches I, Phillips G, et al: Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: Results from a guideline-based performance improvement program. Crit Care Med 2014; 42:1749-1755
37. Cabana MD, Rand CS, Powe NR, et al: Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999; 282:1458-1465
38. Barlow G, Nathwani D, Myers E, et al: Identifying barriers to the rapid administration of appropriate antibiotics in community-acquired pneumonia. J Antimicrob Chemother 2008; 61:442-451
39. Funk DJ, Kumar A: Antimicrobial therapy for life-threatening infections: Speed is life. Crit Care Clin 2011; 27:53-76
40. Croskerry P: From mindless to mindful practice-cognitive bias and clinical decision making. N Engl J Med 2013; 368:2445-2448
41. McIntyre LA, Hébert PC, Fergusson D, et al; Canadian Critical Care Trials Group: A survey of Canadian intensivists' resuscitation practices in early septic shock. Crit Care 2007; 11:R74
42. Reade MC, Huang DT, Bell D, et al; British Association for Emergency Medicine; UK Intensive Care Society; UK Society for Acute Medicine; Australasian Resuscitation in Sepsis Evaluation Investigators; Protocolized Care for Early Septic Shock Investigators: Variability in management of early severe sepsis. Emerg Med J 2010; 27:110-115
43. Kumar A, Ellis P, Arabi Y, et al; Cooperative Antimicrobial Therapy of Septic Shock Database Research Group: Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest 2009; 136:1237-1248
44. van Zanten AR: The golden hour of antibiotic administration in severe sepsis: Avoid a false start striving for gold. Crit Care Med 2014; 42:1931-1932
45. Dean NC, Jones JP, Aronsky D, et al: Hospital admission decision for patients with community-acquired pneumonia: Variability among physicians in an emergency department. Ann Emerg Med 2012; 59:35-41