History of diabetes may delay antibiotic administration in patients with severe sepsis presenting to emergency departments

Abe, Toshikazu; Suzuki, Tomoharu; Kushimoto, Shigeki; Fujishima, Seitaro; Sugiyama, Takehiro; Iwagami, Masao; Ogura, Hiroshi; Shiraishi, Atsushi; Saitoh, Daizoh; Mayumi, Toshihiko; Iriyama, Hiroki; Komori, Akira; Nakada, Taka-Aki; Shiino, Yasukazu; Tarui, Takehiko; Hifumi, Toru; Otomo, Yasuhiro; Okamoto, Kohji; Umemura, Yutaka; Kotani, Joji; Sakamoto, Yuichiro; Sasaki, Junichi; Shiraishi, Shin-Ichiro; Tsuruta, Ryosuke; Hagiwara, Akiyoshi; Yamakawa, Kazuma; Takuma, Kiyotsugu; Masuno, Tomohiko; Takeyama, Naoshi; Yamashita, Norio; Ikeda, Hiroto; Ueyama, Masashi; Gando, Satoshi

History of diabetes may delay antibiotic administration in patients with severe sepsis presenting to emergency departments

Abe, Toshikazu; Suzuki, Tomoharu; Kushimoto, Shigeki et al.

Medicine, 2020, 99(11), e19446

Permalink : https://hdl.handle.net/2115/78183

このアイテムのアクセス数:642件（2026-08-13 22:30 集計）

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https://doi.org/10.1097/MD.0000000000019446			18

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アクセス権	open access
URI	https://hdl.handle.net/2115/78183
タイトル	History of diabetes may delay antibiotic administration in patients with severe sepsis presenting to emergency departments
著者	Abe, Toshikazu ; Suzuki, Tomoharu ; Kushimoto, Shigeki ; Fujishima, Seitaro ; Sugiyama, Takehiro ; Iwagami, Masao ; Ogura, Hiroshi ; Shiraishi, Atsushi ; Saitoh, Daizoh ; Mayumi, Toshihiko ; Iriyama, Hiroki ; Komori, Akira ; Nakada, Taka-Aki ; Shiino, Yasukazu ; Tarui, Takehiko ; Hifumi, Toru ; Otomo, Yasuhiro ; Okamoto, Kohji ; Umemura, Yutaka ; Kotani, Joji ; Sakamoto, Yuichiro ; Sasaki, Junichi ; Shiraishi, Shin-Ichiro ; Tsuruta, Ryosuke ; Hagiwara, Akiyoshi ; Yamakawa, Kazuma ; Takuma, Kiyotsugu ; Masuno, Tomohiko ; Takeyama, Naoshi ; Yamashita, Norio ; Ikeda, Hiroto ; Ueyama, Masashi ; Gando, Satoshi
著者名 Abe, Toshikazu
著者名 Suzuki, Tomoharu
e-Rad_Researcher 50195434 著者名 Kushimoto, Shigeki
e-Rad_Researcher 00173419 著者名 Fujishima, Seitaro
著者名 Sugiyama, Takehiro
e-Rad_Researcher 30830228 著者名 Iwagami, Masao
e-Rad_Researcher 70301265 著者名 Ogura, Hiroshi
e-Rad_Researcher 40401343 著者名 Shiraishi, Atsushi
e-Rad_Researcher 90531632 著者名 Saitoh, Daizoh
e-Rad_Researcher 90281071 著者名 Mayumi, Toshihiko
著者名 Iriyama, Hiroki
著者名 Komori, Akira
e-Rad_Researcher 20375794 著者名 Nakada, Taka-Aki
著者名 Shiino, Yasukazu
著者名 Tarui, Takehiko
著者名 Hifumi, Toru
e-Rad_Researcher 40176946 著者名 Otomo, Yasuhiro
著者名 Okamoto, Kohji
e-Rad_Researcher 20743561 著者名 Umemura, Yutaka
e-Rad_Researcher 80360270 著者名 Kotani, Joji
e-Rad_Researcher 20366678 著者名 Sakamoto, Yuichiro
e-Rad_Researcher 90235250 著者名 Sasaki, Junichi
e-Rad_Researcher 90386243 著者名 Shiraishi, Shin-Ichiro
e-Rad_Researcher 30263768 著者名 Tsuruta, Ryosuke
著者名 Hagiwara, Akiyoshi
e-Rad_Researcher 50597507 著者名 Yamakawa, Kazuma
e-Rad_Researcher 30216824 著者名 Takuma, Kiyotsugu
e-Rad_Researcher 00318528 著者名 Masuno, Tomohiko
e-Rad_Researcher 00155053 著者名 Takeyama, Naoshi
著者名 Yamashita, Norio
著者名 Ikeda, Hiroto
著者名 Ueyama, Masashi
e-Rad_Researcher 30125306 著者名 Gando, Satoshi
言語	英語
キーワード	bundle
	comorbidity
	diabetes mellitus
	protocols
	sepsis
発行日	2020-03
出版者	Lippincott Williams & Wilkins (LWW)
収録物名	Medicine
巻(号)	99(11)
ページ	e19446
抄録	Clinical manifestations of sepsis differ between patients with and without diabetes mellitus (DM), and these differences could influence the clinical behaviors of medical staff. Therefore, we aimed to investigate whether pre-existing DM was associated with the time to antibiotics or sepsis care protocols. This was a retrospective cohort study. It conducted at 53 intensive care units (ICUs) in Japan. Consecutive adult patients with severe sepsis admitted directly to ICUs form emergency departments from January 2016 to March 2017 were included. The primary outcome was time to antibiotics. Of the 619 eligible patients, 142 had DM and 477 did not have DM. The median times (interquartile ranges) to antibiotics in patients with and without DM were 103 minutes (60-180 minutes) and 86 minutes (45-155 minutes), respectively (P = .05). There were no significant differences in the rates of compliance with sepsis protocols or with patient-centred outcomes such as in-hospital mortality. The mortality rates of patients with and without DM were 23.9% and 21.6%, respectively (P = .55). Comparing patients with and without DM, the gamma generalized linear model-adjusted relative difference indicated that patients with DM had a delay to starting antibiotics of 26.5% (95% confidence intervals (95%CI): 4.6-52.8, P = .02). The gamma generalized linear model-adjusted relative difference with multiple imputation for missing data of sequential organ failure assessment was 19.9% (95%CI: 1.0-42.3, P = .04). The linear regression model-adjusted beta coefficient indicated that patients with DM had a delay to starting antibiotics of 29.2 minutes (95%CI: 6.8-51.7, P = .01). Logistic regression modelling showed that pre-existing DM was not associated with in-hospital mortality (odds ratio, 1.26; 95%CI: 0.72-2.19, P = .42). Pre-existing DM was associated with delayed antibiotic administration among patients with severe sepsis or septic shock; however, patient-centred outcomes and compliance with sepsis care protocols were comparable.
資源タイプ	学術雑誌論文
出版タイプ	Version of Record
権利情報	Creative Commons Attribution-NonCommercial 4.0 International
PISSN	0025-7974
関連情報 (isIdenticalTo)	出版社版DOI https://doi.org/10.1097/MD.0000000000019446