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Balandín B, Pintado V, Pérez-Pedrero MJ, Martínez-Sagasti F, Sancho-González M, Soriano-Cuesta C, Gesso CMD, Chicot M, de Luna RR, Asensio-Martín MJ, Catalan M, Díaz-Díaz JJ, Carbonell N, Iranzo R, Royuela A, Ballesteros D. Multicentre study of cefiderocol for treatment of Gram-negative bacteria infections in critically ill patients. Int J Antimicrob Agents 2024; 63:107121. [PMID: 38408494 DOI: 10.1016/j.ijantimicag.2024.107121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/12/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024]
Affiliation(s)
- Bárbara Balandín
- Department of Critical Care Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain.
| | - Vicente Pintado
- Department of Infectious Diseases, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | | | | | - Cruz Soriano-Cuesta
- Department of Critical Care Medicine, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Marta Chicot
- Department of Critical Care Medicine, Hospital Universitario de La Princesa, Madrid, Spain
| | - Rafael Ruiz de Luna
- Department of Critical Care Medicine, Hospital Universitario Fundación de Alcorcón, Madrid, Spain
| | | | - Mercedes Catalan
- Department of Critical Care Medicine, Hospital Universitario Doce de Octubre, Madrid, Spain
| | - Juan José Díaz-Díaz
- Department of Critical Care Medicine, Hospital Universitario de Gran Canaria Doctor Negrín; Gran Canaria, Spain
| | - Nieves Carbonell
- Department of Critical Care Medicine, Hospital Clínico Universitario de Valencia
| | - Reyes Iranzo
- Department of Anesthesiology, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | - Ana Royuela
- Clinical Biostatistics, Puerta de Hierro Biomedical Research Institute (IDIPHISA), CIBERESP, Madrid, Spain
| | - Daniel Ballesteros
- Department of Critical Care Medicine, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
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Méndez R, Figuerola A, Ramasco F, Chicot M, Pascual NF, García Í, von Wernitz A, Zurita ND, Semiglia A, Pizarro A, Saez C, Rodríguez D. Decrease in Mortality after the Implementation of a Hospital Model to Improve Performance in Sepsis Care: Princess Sepsis Code. J Pers Med 2024; 14:149. [PMID: 38392582 PMCID: PMC10890463 DOI: 10.3390/jpm14020149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 01/23/2024] [Accepted: 01/24/2024] [Indexed: 02/24/2024] Open
Abstract
Sepsis is a time-dependent disease whose prognosis is influenced by early diagnosis and therapeutic measures. Mortality from sepsis remains high, and for this reason, the guidelines of the Surviving Sepsis Campaign recommend establishing specific care programs aimed at patients with sepsis. We present the results of the application of a hospital model to improve performance in sepsis care, called Princess Sepsis Code, with the aim of reducing mortality. A retrospective study was conducted using clinical, epidemiological, and outcome variables in patients diagnosed with sepsis from 2015 to 2022. A total of 2676 patients were included, 32% of whom required admission to the intensive care unit, with the most frequent focus of the sepsis being abdominal. Mortality in 2015, at the beginning of the sepsis code program, was 24%, with a declining rate noted over the study period, with mortality reaching 17% in 2022. In the multivariate analysis, age > 70 years, respiratory rate > 22 rpm, deterioration in the level of consciousness, serum lactate > 2 mmol/L, creatinine > 1.6 mg/dL, and the focus of the sepsis were identified as variables independently related to mortality. The implementation of the Princess Sepsis Code care model reduces the mortality of patients exhibiting sepsis and septic shock.
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Affiliation(s)
- Rosa Méndez
- Department of Anaesthesiology and Surgical Intensive Care, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Angels Figuerola
- Department of Preventive Medicine and Public Health, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Fernando Ramasco
- Department of Anaesthesiology and Surgical Intensive Care, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Marta Chicot
- Department of Intensive Care Medicine, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Natalia F Pascual
- Department of Clinical Analysis, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Íñigo García
- Department of General Surgery, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Andrés von Wernitz
- Department of Emergency, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Nelly D Zurita
- Department of Microbiology, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Auxiliadora Semiglia
- Department of Microbiology, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Alberto Pizarro
- Department of Emergency, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Carmen Saez
- Department of Internal Medicine, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain
| | - Diego Rodríguez
- Department of Intensive Care Medicine, Hospital Universitario Príncipe de Asturias, Avenida Principal de La Universidad s/n, 28805 Madrid, Spain
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Méndez R, Figuerola A, Chicot M, Barrios A, Pascual N, Ramasco F, Rodríguez D, García I, von Wernitz A, Zurita N, Semiglia A, Jiménez D, Navarro S, Rubio MJ, Vinuesa M, Del Campo L, Bautista A, Pizarro A. Sepsis Code: dodging mortality in a tertiary hospital. Rev Esp Quimioter 2022; 35:43-49. [PMID: 34812031 PMCID: PMC8790636 DOI: 10.37201/req/105.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Introducción En el hospital de La Princesa comienza el “Código Sepsis” (CSP) en el año 2015, como un grupo multidisciplinar que dota al personal sanitario de herramientas clínicas, analíticas y organizativas, con el objetivo de la detección y el tratamiento precoz del paciente con sepsis. El objetivo de este estudio es evaluar el impacto de la implantación de CSP en la mortalidad y determinar las variables asociadas con un aumento de la misma. Material y métodos Se realizó un estudio analítico retrospectivo de los pacientes con activación de la alerta CSP de 2015 a 2018. Se recogieron variables clínico-epidemiológicas, parámetros analíticos y factores de gravedad como el ingreso en Unidades de Cuidados Críticos (UCC) y la necesidad de aminas. La significación estadística se estableció en una p < 0,05. Resultados Se incluyeron 1.121 pacientes. La estancia media fue de 16 días y un 32% requirieron ingreso en UCC. La mortalidad mostró una tendencia lineal descendente estadísticamente significativa del 24% en 2015 hasta el 15% en 2018. Las variables predictivas de mortalidad con asociación estadísticamente significativa fueron el lactato > 2 mmol/L, la creatinina > 1,6 mg/dL y la necesidad de aminas. Conclusiones La implementación de Código Sepsis disminuye la mortalidad de los pacientes con sepsis y shock séptico. La presencia de una cifra de lactato > 2 mmol/L, los niveles de creatinina > 1,6 mg/dL y/o la necesidad de administrar aminas en las primeras 24 horas, se asocian con un aumento de la mortalidad en el paciente con sepsis.
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Affiliation(s)
- R Méndez
- Rosa Méndez Hernández. Servicio de Anestesia y Reanimación. Hospital Universitario de La Princesa. Calle Diego de León 62. 28006. Madrid, Spain.
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Chicot M, Valenzuela C, Rodríguez DA. Rapidly progressive interstitial lung disease without cutaneous involvement associated to anti-MDA5 antibodies. Med Clin (Barc) 2020; 156:413-414. [PMID: 32143946 DOI: 10.1016/j.medcli.2020.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 12/16/2019] [Accepted: 01/09/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Marta Chicot
- Unidad de Cuidados Intensivos, Hospital de La Princesa, IIS-Princesa, Madrid, España.
| | - Claudia Valenzuela
- Servicio de Neumología, Hospital de La Princesa, IIS-Princesa, Madrid, España; Cátedra ROCHE-UAM, EPID-Futuro, Universidad Autónoma de Madrid (UAM), Madrid, España
| | - Diego A Rodríguez
- Unidad de Cuidados Intensivos, Hospital de La Princesa, IIS-Princesa, Madrid, España
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Ramasco F, Figuerola A, Mendez R, Serrano DR, von Wernitz A, Hernández-Aceituno A, Sáez C, Cardeñoso L, Martin E, García-Vázquez N, de las Cuevas C, Pascual N, Bautista A, Jiménez D, Fernández G, Leal A, Vinuesa M, Pizarro A, di Martino M, Del Campo L, Sanz IG, Chicot M, Barrios A, Rubio MJ. Initial clinical outcomes and prognostic variables in the implementation of a Code Sepsis in a high complexity University Hospital. Rev Esp Quimioter 2019; 32:238-245. [PMID: 30968675 PMCID: PMC6609936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To assess the impact of the first months of application of a Code Sepsis in a high complexity hospital, analyzing patient´s epidemiological and clinical characteristics and prognostic factors. METHODS A long-term observational study was carried out throughout a consecutive period of seven months (February 2015 - September 2015). The relationship with mortality of risk factors, and analytic values was analyzed using uni- and multivariate analyses. RESULTS A total of 237 patients were included. The in-hospital mortality was 24% at 30 days and 27% at 60 days. The mortality of patients admitted to Critical Care Units was 30%. Significant differences were found between the patients who died and those who survived in mean levels of creatinine (2.30 vs 1.46 mg/dL, p <0.05), lactic acid (6.10 vs 2.62 mmol/L, p <0.05) and procalcitonin (23.27 vs 12.73 mg/dL, p<0.05). A statistically significant linear trend was found between SOFA scale rating and mortality (p<0.05). In the multivariate analysis additional independent risk factors associated with death were identified: age > 65 years (OR 5.33, p <0.05), lactic acid > 3 mmol/L (OR 5,85, p <0,05), creatinine > 1,2 mgr /dL (OR 4,54, p <0,05) and shock (OR 6,57, P <0,05). CONCLUSIONS The epidemiological, clinical and mortality characteristics of the patients in our series are similar to the best published in the literature. The study has identified several markers that could be useful at a local level to estimate risk of death in septic patients. Studies like this one are necessary to make improvements in the Code Sepsis programs.
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Affiliation(s)
- Fernando Ramasco
- Anesthesiology and Surgical Critical Care Department, University Hospital of La Princesa, Madrid, Spain.,Correspondence: Fernando Ramasco Anesthesiology and Surgical Critical Care Departament University Hospital of La Princesa, C/ Diego de León 62, Madrid, 28006, Spain. Phone : 639667114 - E-mail:
| | - Angels Figuerola
- Preventive Medicine and Public Health Department, University Hospital of La Princesa, Madrid, Spain
| | - Rosa Mendez
- Anesthesiology and Surgical Critical Care Department, University Hospital of La Princesa, Madrid, Spain
| | - Diego Rodríguez Serrano
- Intensive Care Medicine Department, Universitary Hospital Príncipe de Asturias, Alcalá de Henares, Madrid, Spain
| | | | - Ana Hernández-Aceituno
- Preventive Medicine and Public Health Department, University Hospital of La Princesa, Madrid, Spain
| | - Carmen Sáez
- Internal Medicine and Infectious Disease Departament, University Hospital of La Princesa, Madrid, Spain
| | - Laura Cardeñoso
- Microbiology Department, University Hospital of La Princesa, Madrid, Spain
| | - Elena Martin
- General Surgery Department, University Hospital of La Princesa, Madrid, Spain
| | - Nieves García-Vázquez
- Intensive Care Medicine Departament, University Hospital of La Princesa, Madrid, Spain
| | | | - Natalia Pascual
- Clinical Analysis Department, University Hospital of La Princesa, Madrid, Spain
| | - Azucena Bautista
- Internal Medicine and Infectious Disease Departament, University Hospital of La Princesa, Madrid, Spain
| | - David Jiménez
- Nurse of Intensive Care Medicine Department, University Hospital of La Princesa, Madrid, Spain
| | - Guillermo Fernández
- Admission and Clinical Documentation Department, University Hospital of La Princesa, Madrid, Spain
| | - Ana Leal
- Intensive Care Medicine Departament, University Hospital of La Princesa, Madrid, Spain
| | - Mercedes Vinuesa
- Preventive Medicine and Public Health Department, University Hospital of La Princesa, Madrid, Spain
| | - Alberto Pizarro
- Emergency Department, University Hospital of La Princesa, Madrid, Spain
| | - Marcello di Martino
- General Surgery Department, University Hospital of La Princesa, Madrid, Spain
| | - Lourdes Del Campo
- Radiology Department, University Hospital of La Princesa, Madrid, Spain
| | - Iñigo García Sanz
- General Surgery Department, University Hospital of La Princesa, Madrid, Spain
| | - Marta Chicot
- Intensive Care Medicine Departament, University Hospital of La Princesa, Madrid, Spain
| | - Ana Barrios
- Internal Medicine and Infectious Disease Departament, University Hospital of La Princesa, Madrid, Spain
| | - María José Rubio
- Nurse and Quality and Teaching Supervisor, University Hospital of La Princesa, Madrid, Spain
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Chicot M, Sarraj A, Aguilar E, Rodríguez DA. Vegetation with a lizard-tail appearance in the left atrium. Med Intensiva 2016; 41:577. [PMID: 27461095 DOI: 10.1016/j.medin.2016.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/13/2016] [Accepted: 04/17/2016] [Indexed: 10/21/2022]
Affiliation(s)
- M Chicot
- Servicio de Medicina Intensiva, Hospital Universitario de La Princesa, Madrid, Spain
| | - A Sarraj
- Servicio de Cirugía Cardiaca, Hospital Universitario de La Princesa, Madrid, Spain
| | - E Aguilar
- Servicio de Cirugía Cardiaca, Hospital Universitario de La Princesa, Madrid, Spain
| | - D A Rodríguez
- Servicio de Medicina Intensiva, Hospital Universitario de La Princesa, Madrid, Spain.
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Bernis C, Chicot M, Ferreiros R, Rodriguez- Serrano DA, Salanova L, Cereijo JE, Sanchez Tomero JA. MP196PROSNOSTIC VALUE OF URINE NGAL (UNGAL) AND IL18 (UIL18) IN CRITICAL ILL PATIENTS AT THE ADMISSION TO AN INTENSIVE CARE UNIT (ICU). Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw187.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Bernis C, Chicot M, Ferreirós R, Salanova L, Rodriguez-Serrano D, Cereijo JE, Sanchez-Tomero JA. SP221NGAL AND LONG TERM EVOLUTION FROM ACUTE KIDNEY INJURY:A PROSPECTIVE STUDY IN CRITICAL ILL PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv190.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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