Automated screening of natural language in electronic health records for the diagnosis septic shock is feasible and outperforms an approach based on explicit administrative codes
Publication date: Available online 9 January 2020Source: Journal of Critical CareAuthor(s): Joris Vermassen, Kirsten Colpaert, Liesbet De Bus, Pieter Depuydt, Johan DecruyenaereAbstractPurposeIdentification of patients for epidemiologic research through administrative coding has important limitations. We investigated the feasibility of a search based on natural language processing (NLP) on the text sections of electronic health records for identification of patients with septic shock.Materials and methodsResults of an explicit search strategy (using explicit concept retrieval) and a combined search strategy (using both explicit and implicit concept retrieval) were compared to hospital ICD-9 based administrative coding and to our department's own prospectively compiled infection database.ResultsOf 8911 patients admitted to the medical or surgical ICU, 1023 (11.5%) suffered from septic shock according to the combined search strategy. This was significantly more than those identified by the explicit strategy (518, 5.8%), by hospital administrative coding (549, 5.8%) or by our own prospectively compiled database (609, 6.8%) (p
We describe the clinical outcomes of adults who received ECMO in septic shock.MethodsWe retrospectively studied adults supported on veno-arterial or veno-venous modes of ECMO with septic shock at the time of cannulation from 1/1/2009-12/31/2016 at a quaternary medical center in the United States. The primary outcome was rate of survival to hospital discharge and time to survival using Kaplan-Meier survival estimates. We analyzed survival by mode, previous cardiac arrest and timing of cannulation (
Authors: Fernández Conesa M, Milena Muñoz A, Valero González MÁ Abstract We read with interest the article by Guido Villa-Gómez, Manuel Alejandro Mahler and Dante Manazzoni "A new case of pseudoaneurysm of the right hepatic artery secondary to laparoscopic cholecystectomy". A 57-year-old cholecystectomized female was admitted due to abdominal pain with an analytical pattern of cholestasis and liver enzyme alterations, with cholangitis that progressed to septic shock of a biliary origin with gradual anemia and hypotension. PMID: 32054281 [PubMed - as supplied by publisher]
Conclusions: Current randomized evidence showed that continuous IV administration of epinephrine as inotropic/vasopressor agent is not associated with a worse outcome in critically ill patients.
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Conclusions: Sepsis affects a fifth of patients admitted to ICUs in mainland China with a 90-day mortality rate of 35.5%. Our findings indicate that a large burden of sepsis, and we need to focus on sepsis as a quality improvement target in China given the high mortality. In addition, further studies are needed to delineate the epidemiology of sepsis outside the ICU.
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Conclusion: Sepsis remains common, costly to treat, and presages significant mortality for Medicare beneficiaries.
Conclusions: A sepsis inpatient admission is associated with marked increase in risk of death that is comparable to the risks associated with inpatient admissions for other common and serious chronic illnesses. The aggregate costs of sepsis care for Medicare beneficiaries will continue to increase.
Objectives: A companion article reports the trajectory of long-term mortality and significant health-related quality of life disability among children encountering septic shock. In this article, the investigators examine critical illness factors associated with these adverse outcomes. Design: Prospective, cohort-outcome study, conducted 2013–2017. Setting: Twelve United States academic PICUs. Patients: Critically ill children, 1 month to 18 years, with community-acquired septic shock requiring vasoactive-inotropic support. Interventions: Illness severity, organ dysfunction, and resource utilization data...
Conclusions: This investigation provides the first longitudinal description of long-term mortality and clinically relevant, health-related quality of life morbidity among children encountering community-acquired septic shock. Although in-hospital mortality was 9%, 35% of survivors demonstrated significant, health-related quality of life deterioration from baseline that persisted at least 1 year following hospitalization for septic shock.