When people with severe sepsis, an extreme over-reaction by the body to a serious infection, come to the emergency room (ER), they seek timely, expert help to prevent organ failure and even death. When that care involves the early involvement of an infectious disease specialist (ID), patient mortality can be reduced by as much as 40 percent, according to a new retrospective, single-center study published in Open Forum on Infectious Diseases.
If you or a loved one has a serious infection, including sepsis, then having a doctor for infectious diseases as part of a team of doctors who care for you is likely to result in better outcomes. You should ask your doctor for a contagious disease to see you if it is available at your hospital. "
Dr. Teresa Madaline, Principal Author of Studies and Assistant Professor of Medicine at Albert Einstein College of Medicine and Health at the Montefiore Health System in New York
In-hospital mortality was 40 percent lower in patients with severe sepsis and septic shock whose care included ID card consultation within 12 hours of the arrival of ER, compared to patients who had not been seen by an ID card at that time. The study, which included 248 patients with severe sepsis, observed from 2017 to 2018 at the D.C. Hospital. Wheeler, of the Montevideo Health System, also found that antibiotic prescriptions for these patients were stopped sooner when an ID card consultation took place. While antibiotics may initially save, they can cause harmful side effects, especially when taken for extended periods. The results of a diagnostic test can help guide and refine antibiotic treatment over time so that medication can be reduced, as appropriate.
"It is very important to use antibiotics in the shortest period of time that is appropriate to save the patient the potential adverse effects of the drugs," Dr Madaline said. "This is a really key way for the infectious disease consultation to make a difference."
Unlike previous research in this area, the new study focused only on patients who received recommended seizure care within three hours. This has allowed researchers to specifically consider the clinical benefits of early ID card consulting and distinguish it from improved adherence to recommended standards, which can also positively impact patient outcomes.
The continuity that ID card doctors are able to provide as a patient with severe sepsis transitions from one team of caregivers in the ER to another in the hospital can provide care teams with a greater degree of confidence when deciding to quit. with antibiotic treatment. Further research is needed to determine how early ID card consultations affect this decision-making process and to identify which aspects of involvement of these specialists initially in patient care are most important, said Dr. Madalin.
Meanwhile, new findings add to the growing evidence that ID cards have a beneficial effect on outcomes for patients with sepsis and other infection-related conditions.
"Infectious disease specialists are great partners for other physicians in different patient care specialties," said Dr. Madalin. "It is important to continue research on how ID card specialists can best work with other service providers to optimize patient outcomes and how early consultation models can be adapted to different environments. Diagnosis and treatment of difficult sepsis can be a huge challenge, so it is important to remember that there is no 'no one at all' model for improving outcomes for people affected by this condition. "
American Infectious Diseases Association