Current Practice of Management of Bacteremic Sepsis: A Study in a Tertiary Care Teaching Hospital in Japan.
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- AOKI Yosuke
- the Department of Medicine, Saga Medical School
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- FUKUOKA Mami
- the Department of Medicine, Saga Medical School
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- KUSABA Koji
- Clinical Laboratory for Microbiology, Saga Medical School
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- TANABE Ichiro
- Clinical Laboratory for Microbiology, Saga Medical School
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- NAGASAWA Zenzo
- Clinical Laboratory for Microbiology, Saga Medical School
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- TOMINAGA Masaki
- the Department of Medicine, Saga Medical School
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- HAYASHI Shinichiro
- the Department of Medicine, Saga Medical School
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- TADANO Jutaro
- Clinical Laboratory for Microbiology, Saga Medical School
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- NAGASAWA Kohei
- the Department of Medicine, Saga Medical School
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Objective To investigate how patients with bacteremic sepsis are managed in a tertiary care teaching hospital.<br> Patients and Methods Prospective observational study on patients with bacteremic sepsis. Clinical and microbio-logical characteristics of bacteremic sepsis were analyzed in relation to prognosis. Severity of the illness was quantitatively analyzed by the APACHE (Acute Physiology, Age, Chronic Health Evaluation) III scoring system. Also investigated was how closely physicians paid attention to acute physiological alterations in patients.<br> Results The 28-day mortalities in fifty hemodynamically stable patients and in twenty-three septic shock patients were 26% and 52%, respectively (p=0.028). Gram-positive organisms accounted for 54% of all organisms, with the mortality and incidence of septic shock being the same as with Gram-negative infections. The mean APACHE III score was 42.9 in survivors, and 76.5 in non-survivors (p < 0.001). Although serum levels of C-reactive protein and acute physiology score (APS) was significantly higher in non-survivors than in survivors, the correlation with APACHE III score was more prominent in APS. The number of vital signs recorded was 1.67 in physicians and 3.6 in nurses (p < 0.001).<br> Conclusions The present study proved that the APACHE HI score accurately discriminates between survivors and non-survivors of patients with sepsis. By addressing the need for an objective evaluation of severity of illness, it strongly recommends that physicians should be made aware of physiologically defined sepsis and that they should pay closer attention to patients' physiological alterations to identify the development of sepsis in critically ill patients.<br>(Internal Medicine 39: 901-909, 2000)
収録刊行物
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- Internal Medicine
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Internal Medicine 39 (11), 901-909, 2000
一般社団法人 日本内科学会
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詳細情報 詳細情報について
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- CRID
- 1390282679843150592
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- NII論文ID
- 10006997064
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- NII書誌ID
- AA10827774
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- COI
- 1:STN:280:DC%2BD3crhtVOqtw%3D%3D
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- ISSN
- 13497235
- 09182918
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- NDL書誌ID
- 5540416
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- PubMed
- 11065240
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可