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International Journal of Emergency Medicine

, Volume 3, Issue 4, pp 293–298

First Online: 21 August 2010Received: 28 April 2010Accepted: 05 July 2010


BackgroundPatients who are admitted with a suspicion of a severe infection usually enter the hospital through the emergency department ED. The recognition of prognostic factors in an early stage affects further treatment and might improve clinical outcomes.

AimsWe examined possible prognostic factors for four important outcomes: intensive care unit ICU admission, positive blood cultures, mortality and re-admission.

MethodsAll adult patients arriving at the ED with a suspected infection for whom admittance and intravenous iv antibiotics were indicated were included between March and December 2006. Possible prognostic variables were obtained from medical history, physical examination and laboratory results during the ED presentation. Data were analysed using logistic regression analysis.

ResultsA total of 295 ED patients were evaluated, of whom 27 were referred to the ICU, 62 had a positive blood culture, 16 died and 48 were re-admitted. In multivariate analysis, patients with a respiration rate of >25-min were at higher risk for ICU admission. Patients with a positive blood culture had a higher heart rate and a higher percentage of segmented neutrophils. Patients who died during admission were more likely to be older, confused and had lower blood pressure. Patients who were re-admitted within 30 days were more likely to be male, younger and less likely to have a positive blood culture.

ConclusionsRoutine clinical and biochemical information can be used to predict ICU admission, the presence of bacteraemia, mortality and re-admission within 30 days and should be taken into consideration for treatment decisions.

KeywordsInfection Prognostic factors ICU admission Bacteraemia Mortality Re-admission The views expressed in this paper are those of the authors and not those of the editors, editorial board or publisher.

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Autor: Charlotte F. J. van Tuijn - Maria Prins - Jan S. Luitse - Suzanne E. Geerlings


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