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Early Infectious Diseases Consult May Lower Sepsis Mortality

In-hospital mortality reduced among patients receiving severe sepsis, septic shock treatment bundle

THURSDAY, Oct. 31, 2019 (HealthDay News) — Early infectious diseases (ID) consultation is associated with a reduction in in-hospital mortality for patients receiving a severe sepsis and septic shock (SS/SS) treatment bundle, according to a study published online Oct. 31 in Open Forum Infectious Diseases.

Theresa Madaline, M.D., from the Montefiore Medical Center in Bronx, New York, and colleagues compared outcomes for 111 adult emergency department patients with ID consultation within 12 hours of triage to outcomes of 137 patients who received standard care.

The researchers found that in the early ID group, in-hospital mortality was lower in an unadjusted analysis (24.3 versus 38.0 percent; P = 0.02) and after adjustment for covariates (odds ratio, 0.47; 95 percent confidence interval, 0.25 to 0.89; P = 0.02). Among patients who survived, there was no significant difference in 30-day readmission (22.6 versus 23.5 percent; P = 0.89) or median length of stay (10.2 versus 12.1 days; P = 0.15). The early ID group had a trend toward shorter time to antibiotic de-escalation (log-rank test P = 0.07). After adjustment, early ID consultation was protective of in-hospital mortality (adjusted subdistribution hazard ratio [asHR], 0.60; 95 percent confidence interval, 0.36 to 1.00; P = 0.497) and predictive of discharge alive (asHR, 1.58; 95 percent confidence interval, 1.11 to 2.23; P = 0.01).

“ID consultation as part of a team-based care approach is associated with improved patient outcomes, and addition of ID consultation to sepsis bundles should be considered,” the authors write.

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