About: Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study
Creator	Brun-Buisson, Christian Roux, Damien Guérot, Emmanuel Mayaux, Julien Maury, Eric De Prost, Nicolas Dessap, Armand Contou, Damien Coudroy, Rémi Grimaldi, David Jochmans, Sébastien Plantefève, Gaëtan Ricome, Sylvie
Source	PMC
abstract	BACKGROUND: The lack of a patent source of infection after 24 hours of management of shock considered septic is a common and disturbing scenario. We aimed to determine the prevalence and the causes of shock with no diagnosis 24 hours after its onset, and to compare the outcomes of patients with early-confirmed septic shock to those of others. METHODS: We conducted a pragmatic, prospective, multicenter observational cohort study in ten intensive care units (ICU) in France. We included all consecutive patients admitted to the ICU with suspected septic shock defined by clinical suspicion of infection leading to antibiotic prescription plus acute circulatory failure requiring vasopressor support. RESULTS: A total of 508 patients were admitted with suspected septic shock. Among them, 374 (74 %) had early-confirmed septic shock, while the 134 others (26 %) had no source of infection identified nor microbiological documentation retrieved 24 hours after shock onset. Among these, 37/134 (28 %) had late-confirmed septic shock diagnosed after 24 hours, 59/134 (44 %) had a condition mimicking septic (septic shock mimicker, mainly related to adverse drug reactions, acute mesenteric ischemia and malignancies) and 38/134 (28 %) had shock of unknown origin by the end of the ICU stay. There were no differences between patients with early-confirmed septic shock and the remainder in ICU mortality and the median duration of ICU stay, of tracheal intubation and of vasopressor support. The multivariable Cox model showed that the risk of day-60 mortality did not differ between patients with or without early-confirmed septic shock. A sensitivity analysis was performed in the subgroup (n = 369/508) of patients meeting the Sepsis-3 definition criteria and displayed consistent results. CONCLUSIONS: One quarter of the patients admitted in the ICU with suspected septic shock had no infection identified 24 hours after its onset and almost half of them were eventually diagnosed with a septic shock mimicker. Outcome did not differ between patients with early-confirmed septic shock and other patients. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13054-016-1537-5) contains supplementary material, which is available to authorized users.
has issue date	2016-11-06(xsd:dateTime)
bibo:doi	10.1186/s13054-016-1537-5
bibo:pmid	27816060
has license	cc-by
sha1sum (hex)	908f2036b52374b60e06bf3697f2d7e08cf4b7fb
schema:url	https://doi.org/10.1186/s13054-016-1537-5
resource representing a document's title	Septic shock with no diagnosis at 24 hours: a pragmatic multicenter prospective cohort study
has PubMed Central identifier	PMC5097846
has PubMed identifier	27816060
schema:publication	Crit Care
resource representing a document's body	covid:908f2036b52374b60e06bf3697f2d7e08cf4b7fb#body_text
is schema:about of	named entity 'onset' named entity 'circulatory failure' named entity 'ICU' named entity 'ADMITTED TO' named entity 'ITS' named entity 'IS A' named entity 'ONSET' named entity 'CLINICAL' named entity 'PRESCRIPTION' named entity 'cohort study' named entity 'patients' named entity 'common' named entity 'multicenter' named entity 'suspicion' named entity 'ICU' named entity 'cohort study' named entity 'patent' named entity 'intensive care units' named entity 'France' named entity 'shock' named entity 'France' named entity 'patent' named entity 'septic shock' named entity 'microbiological' named entity 'Kaplan-Meier' named entity 'diabetes mellitus' named entity 'infection' named entity 'ICU' named entity 'septic shock' named entity 'vasopressor' named entity 'infection' named entity 'multidetector CT' named entity 'hazard ratio' named entity 'microorganism' named entity 'log-rank test' named entity 'post-mortem' named entity 'Sepsis' named entity 'ketoacidosis' named entity 'serum lactate' named entity 'neuroleptic' named entity 'biomarkers' named entity 'clinical phenotype' named entity 'clinical phenotype' named entity 'septic shock' named entity 'mortality rate' named entity 'infectious process' named entity 'microbiological' named entity 'air embolism' named entity 'infection' named entity 'septic shock' named entity 'vascular disease' named entity 'microbiological' named entity 'autopsy' named entity 'autopsy studies' named entity 'sepsis' named entity 'antibiotic therapy' named entity 'neutropenia' named entity 'infectious disease' named entity 'abdomen' named entity 'microbiological' named entity 'infection' named entity 'acute respiratory distress syndrome' named entity 'hemorrhagic shock' named entity 'Cox model' named entity 'microbiological' named entity 'inflammatory diseases' named entity 'non-infectious' named entity 'autopsy' named entity 'imaging procedures'

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