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The early chain of care in bacteraemia patients: early suspicion, treatment and survival in prehospital emergency care
University of Borås.
University of Borås.
South Älvsborg's Hospital.
Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. University of Borås. (iCARE)ORCID iD: 0000-0001-7865-3480
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2018 (English)In: American Journal of Emergency Medicine, ISSN 0735-6757, E-ISSN 1532-8171Article in journal (Refereed) Epub ahead of print
Abstract [en]

Introduction

Bacteraemia is a first stage for patients risking conditions such as septic shock. The primary aim of this study is to describe factors in the early chain of care in bacteraemia, factors associated with increased chance of survival during the subsequent 28 days after admission to hospital. Furthermore, the long-term outcome was assessed.

Methods

This study has a quantitative design based on data from Emergency Medical Services (EMS) and hospital records.

Results

In all, 961 patients were included in the study. Of these patients, 13.5% died during the first 28 days. The EMS was more frequently used by non-survivors. Among patients who used the EMS, the suspicion of sepsis already on scene was more frequent in survivors. Similarly, EMS personnel noted the ESS code “fever, infection” more frequently for survivors upon arriving on scene. The delay time from call to the EMS and admission to hospital until start of antibiotics was similar in survivors and non-survivors. The five-year mortality rate was 50.8%. Five-year mortality was 62.6% among those who used the EMS and 29.5% among those who did not (p < 0.0001).

Conclusion

This study shows that among patients with bacteraemia who used the EMS, an early suspicion of sepsis or fever/infection was associated with improved early survival whereas the delay time from call to the EMS and admission to hospital until start of treatment with antibiotics was not. 50.8% of all patients were dead after five years.

Place, publisher, year, edition, pages
Elsevier, 2018.
Keywords [en]
Bacteraemia, Infection, Emergency Medical Services, Emergency care, Prehospital emergency care, Sepsis
National Category
Infectious Medicine
Research subject
Health and Caring Sciences, Caring Science
Identifiers
URN: urn:nbn:se:lnu:diva-74688DOI: 10.1016/j.ajem.2018.04.004OAI: oai:DiVA.org:lnu-74688DiVA, id: diva2:1210872
Available from: 2018-05-29 Created: 2018-05-29 Last updated: 2018-09-06

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Bremer, Anders

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