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It takes an intensivist.
Am J Surg. 2011 Mar; 201(3):320-3; discussion 323.AJ

Abstract

BACKGROUND

Our institution initiated the implementation of the Surviving Sepsis Campaign guidelines in 2006. We hypothesize that the addition of a surgical intensivist improved results more than the implementation of the guidelines alone.

METHODS

We collected data on 273 patients who were admitted to the surgical intensive care unit for sepsis. The groups were divided into pre-bundle, n = 19; bundle, n = 186; and bundle-plus, n = 68, to denote the method by which the patients were treated for sepsis.

RESULTS

There was no difference in age or sex between groups. There was a statistically significant decrease in length of stay (LOS) between the 3 groups, and in mortality between the bundle and bundle-plus treatment groups (P < .01). In addition, there was an average cost savings between each group.

CONCLUSIONS

Implementation of evidence-based guidelines decreased LOS and decreased cost in our surgical intensive care unit. By adding the expertise of a surgical intensivist, we reduced LOS, cost, and relative risk of death even further than using the guidelines alone.

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Authors+Show Affiliations

Silverman LZ
St. Joseph Mercy Hospital, Ann Arbor, MI 48106, USA.
Hoesel LM
No affiliation info available
Desai A
No affiliation info available
Posa P
No affiliation info available
Purtill MA
No affiliation info available
Brandt MM
No affiliation info available

MeSH

AdultAgedAged, 80 and overCritical CareEvidence-Based MedicineHealth Care CostsHumansLeadershipMiddle AgedPatient Care TeamPractice Guidelines as TopicRetrospective StudiesSepsisShock, SepticSurvival AnalysisTime Factors

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21367371

Citation

Silverman, Lora Z., et al. "It Takes an Intensivist." American Journal of Surgery, vol. 201, no. 3, 2011, pp. 320-3; discussion 323.
Silverman LZ, Hoesel LM, Desai A, et al. It takes an intensivist. Am J Surg. 2011;201(3):320-3; discussion 323.
Silverman, L. Z., Hoesel, L. M., Desai, A., Posa, P., Purtill, M. A., & Brandt, M. M. (2011). It takes an intensivist. American Journal of Surgery, 201(3), 320-3; discussion 323. https://doi.org/10.1016/j.amjsurg.2010.09.013
Silverman LZ, et al. It Takes an Intensivist. Am J Surg. 2011;201(3):320-3; discussion 323. PubMed PMID: 21367371.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - It takes an intensivist. AU - Silverman,Lora Z, AU - Hoesel,L Marco, AU - Desai,Aken, AU - Posa,Patricia, AU - Purtill,Mary-Anne, AU - Brandt,Mary-Margaret, PY - 2010/08/10/received PY - 2010/09/22/revised PY - 2010/09/22/accepted PY - 2011/3/4/entrez PY - 2011/3/4/pubmed PY - 2011/5/4/medline SP - 320-3; discussion 323 JF - American journal of surgery JO - Am J Surg VL - 201 IS - 3 N2 - BACKGROUND: Our institution initiated the implementation of the Surviving Sepsis Campaign guidelines in 2006. We hypothesize that the addition of a surgical intensivist improved results more than the implementation of the guidelines alone. METHODS: We collected data on 273 patients who were admitted to the surgical intensive care unit for sepsis. The groups were divided into pre-bundle, n = 19; bundle, n = 186; and bundle-plus, n = 68, to denote the method by which the patients were treated for sepsis. RESULTS: There was no difference in age or sex between groups. There was a statistically significant decrease in length of stay (LOS) between the 3 groups, and in mortality between the bundle and bundle-plus treatment groups (P < .01). In addition, there was an average cost savings between each group. CONCLUSIONS: Implementation of evidence-based guidelines decreased LOS and decreased cost in our surgical intensive care unit. By adding the expertise of a surgical intensivist, we reduced LOS, cost, and relative risk of death even further than using the guidelines alone. SN - 1879-1883 UR - https://www.unboundmedicine.com/medline/citation/21367371/It_takes_an_intensivist_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9610(10)00703-8 DB - PRIME DP - Unbound Medicine ER -