The ACCP-SCCM Consensus Conference on Sepsis and Organ Failure

Bone, Roger C.; Sibbald, William J.; Sprung, Charles L.

doi:10.1378/chest.101.6.1481

Cited by 645 publications

(455 citation statements)

References 8 publications

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“…Initial clinical manifestation and Pitt bacteremia scores were defined as described elsewhere. 8,9 Identification and susceptibility testing of clinical isolates was performed using the MicroScan (Dade Behring, Newark, DE, USA) system.…”

Section: Methodsmentioning

confidence: 99%

The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia

Choi

Lee

Choi

et al. 2009

Journal of Infection

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Section: Methodsmentioning

confidence: 99%

The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia

Choi

Lee

Choi

et al. 2009

Journal of Infection

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“…Respiratory failure was defined as the requirement for mechanical ventilation beyond 24 h after surgery. Acute respiratory distress syndrome and multiple organ failure were as defined by Bone et al (1992). Sepsis required evidence of SIRS with microbiological evidence of infection, and the diagnosis of pneumonia required either positive sputum cultures or a clear clinical and radiographic evidence of consolidation.…”

Section: Clinical and Radiological Assessmentmentioning

confidence: 99%

Long-term activation of the pro-coagulant response after neoadjuvant chemoradiation and major cancer surgery

et al. 2009

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BACKGROUND: The association between cancer, major surgery and venous thromboembolism (VTE) is well established. Multimodal therapy is increasingly being used as standard treatment for localised gastrointestinal cancer. The aim of this study was to examine the markers of pro-coagulation response and VTE risk in an exemplar multimodal model of pre-operative combination chemotherapy and radiation therapy, followed by complex cancer surgery. METHODS: Consecutive patients (n ¼ 36) with localised oesophageal cancer were studied at baseline after the first and second cycles of chemoradiation, and on post-operative days 1 -28, and at 3, 6 and 9 months. Factors regulating the pro-and anti-coagulant response, as well as pro-inflammatory markers including NFkB activation in peripheral blood mononuclear cells, were examined. All patients received enoxaparin 40 mg s.c. postoperatively up to discharge, and underwent pulmonary CT-pulmonary angiography and venography on day 10 postoperatively. RESULTS: Four (11%) non-fatal thromboembolic events were documented, all after hospital discharge. Neoadjuvant therapy before surgery activated factor VIII (FVIII) and pro-inflammatory NFkB, and increased D-dimers, pro-thrombin fragment 1 þ 2 (F1 þ 2) and the thrombin-anti-thrombin complex (TAT). Surgery significantly (Po0.05) increased pro-thrombin time (PT), activated partial thromboplastin time, fibrinogen, D-dimers, TAT, F1 þ 2 and FVIII up to 6 months. CONCLUSION: These data highlight the linked pro-coagulant and immunoinflammatory pathways in the multimodal management of oesophageal cancer, and suggest that the duration of current standard thromboprophylaxis regimens warrants further study.

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“…8 Quartin and colleagues, however, showed that risk of mortality remained higher for up to five years after sepsis, even compared with carefully matched controls in hospital with similar burden of comorbidity at baseline 10. Quartin and colleagues, however, assessed patients admitted to hospital in the mid-1980s—before the development of a consensus definition for sepsis11 and before widespread improvements in recognition and treatment of sepsis2 3 4 5—and were able to account for only a limited number of potential confounders. Because of the limitations of existing literature, experts have recently called for additional epidemiological studies of late mortality attributable to sepsis that use patient level data to deal with confounding 12…”

Section: Introductionmentioning

confidence: 99%

“…We looked at patients with sepsis compared with three control groups: adults not currently in hospital, patients in hospital with non-sepsis infection, and patients in hospital with an acute sterile inflammatory process. These comparisons allowed us to determine the excess mortality associated with sepsis (including that associated with admission to hospital) and the incremental excess mortality associated with sepsis, beyond what is associated with admission for the two cardinal features of sepsis11 13 14: infection (by comparing sepsis with inflammatory conditions not caused by infection) and inflammation (by comparing sepsis with infections without evidence of inflammatory storm).…”

Section: Introductionmentioning

confidence: 99%

Late mortality after sepsis: propensity matched cohort study

Prescott

Osterholzer

Langa

et al. 2016

BMJ

249

205

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Objectives To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself.Deign Observational cohort study.Setting US Health and Retirement Study.Participants 960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage who were admitted to hospital with sepsis. Patients were matched to 777 adults not currently in hospital, 788 patients admitted with non-sepsis infection, and 504 patients admitted with acute sterile inflammatory conditions.Main outcome measures Late (31 days to two years) mortality and odds of death at various intervals.Results Sepsis was associated with a 22.1% (95% confidence interval 17.5% to 26.7%) absolute increase in late mortality relative to adults not in hospital, a 10.4% (5.4% to 15.4%) absolute increase relative to patients admitted with non-sepsis infection, and a 16.2% (10.2% to 22.2%) absolute increase relative to patients admitted with sterile inflammatory conditions (P<0.001 for each comparison). Mortality remained higher for at least two years relative to adults not in hospital.Conclusions More than one in five patients who survives sepsis has a late death not explained by health status before sepsis.

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The ACCP-SCCM Consensus Conference on Sepsis and Organ Failure

Cited by 645 publications

References 8 publications

The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia

The clinical significance of concurrent Staphylococcus aureus bacteriuria in patients with S. aureus bacteremia

Long-term activation of the pro-coagulant response after neoadjuvant chemoradiation and major cancer surgery

Late mortality after sepsis: propensity matched cohort study

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