The purpose of this study is to determine factors which predict a complicated hospital course and then to develop from these findings an Emergency Department guideline to assist in knowing who is at highest risk of elderly patients with infection presenting for care.
The study is looking at how closely physicians adhere to treatment guidelines in caring for elderly patients, and then to determine if there are differences in elderly patient disease symptoms that result in a failure to use guidelines. If this is known, physicians can then be aware of these differences and provide appropriate care.
Study Type
OBSERVATIONAL
Enrollment
213
The Ohio State University Medical Center
Columbus, Ohio, United States
Complicated Clinical course
The presense of any one of the following will constitute a complicated clinical course: 1. mortality at 30 days 2. requirement for ICU admission or ICU-level care withing first 48 hours 3. positive blood cultures
Time frame: 0-30 days from ED visit
Inadequate process of care
failure to meet any one of the following will be considered inadequate processes of care: 1. obtain blood cultures prior to antibiotic administration 2. administration of antibiotics within 4 hours of presentation 3. measure serum lactate if patient has severe sepsis in the ED 4. Fluid resuscitation of 20-40cc/kg if mean arterial perssure is \<65mmHg despite fluid resuscitation
Time frame: entire length of Emergency Department visit and hospitalization
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