Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30529
Title: Temporal changes in the epidemiology of sepsis-related intensive care admissions from the emergency department in Australia and New Zealand.
Austin Authors: Jones, Daryl A ;Moran, John;Udy, Andrew;Pilcher, David;Delaney, Anthony;Peake, Sandra L
Affiliation: Australian and New Zealand Intensive Care Society Centre for Outcome and Resource Evaluation, Melbourne, Victoria, Australia..
Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia..
Division of Critical Care, The George Institute for Global Health, Sydney, New South Wales, Australia..
Northern Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia..
Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia..
Department of Intensive Care and Hyperbaric Medicine, Alfred Health, Melbourne, Victoria, Australia..
Department of Intensive Care Medicine, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia..
School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia..
Department of Critical Care Research, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia..
Intensive Care
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia..
The University of Melbourne, Melbourne, Victoria, Australia..
Issue Date: 3-Jul-2022
Date: 2022
Publication information: Emergency Medicine Australasia: EMA 2022
Abstract: The Australasian Resuscitation in Sepsis Evaluation (ARISE) study researched septic shock treatment within EDs. This study aims to evaluate whether: (i) conduct of the ARISE study was associated with changes in epidemiology and care for adults (≥18 years) admitted from EDs to ICUs with sepsis in Australia and New Zealand; and (ii) such changes differed among 45 ARISE trial hospitals compared with 120 non-trial hospitals. Retrospective study using interrupted time series analysis in three time periods; 'Pre-ARISE' (January 1997 to December 2007), 'During ARISE' (January 2008 to May 2014) and 'Post-ARISE' (June 2014 to December 2017) using data from the Australian and New Zealand Intensive Care Society Adult Patient Database. Over 21 years there were 54 121 ICU admissions from the ED with sepsis; which increased from 8.1% to 16.4%; 54.6% male, median (interquartile range) age 66 (53-76) years. In the pre-ARISE period, pre-ICU ED length of stay (LOS) decreased in trial hospitals but increased in non-trial hospitals (P = 0.174). During the ARISE study, pre-ICU ED LOS declined more in trial hospitals (P = 0.039) as did the frequency of mechanical ventilation in the first 24 h (P = 0.003). However, ICU and hospital LOS, in-hospital mortality and risk of death declined similarly in both trial and non-trial hospitals. Sepsis-related admissions increased from 8.1% to 16.4%. During the ARISE study, there was more rapid ICU admission and decreased early ventilation. However, these changes were not sustained nor associated with decreased risk of death or duration of hospitalisation.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30529
DOI: 10.1111/1742-6723.14034
ORCID: https://orcid.org/0000-0002-6446-3595
https://orcid.org/0000-0002-6284-2022
https://orcid.org/0000-0001-6682-7973
Journal: Emergency medicine Australasia : EMA
PubMed URL: 35785438
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/35785438/
Type: Journal Article
Subjects: Australasian Resuscitation in Sepsis Evaluation (ARISE) study
emergency department
sepsis
translational research
Appears in Collections:Journal articles

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