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1. Decrease in Mortality after the Implementation of a Hospital Model to Improve Performance in Sepsis Care: Princess Sepsis Code.

Author

Méndez, Rosa, Figuerola, Angels, Ramasco, Fernando, Chicot, Marta, Pascual, Natalia F., García, Íñigo, von Wernitz, Andrés, Zurita, Nelly D., Semiglia, Auxiliadora, Pizarro, Alberto, Saez, Carmen, and Rodríguez, Diego

Subjects
SEPSIS, SEPTIC shock, HOSPITAL mortality, INTENSIVE care units, PRINCESSES
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. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Sepsis Code: dodging mortality in a tertiary hospital

Author

A Semiglia, David Alias Jiménez, N Zurita, A Bautista, L. Del Campo, R Mendez, A Barrios, A von Wernitz, D Rodríguez, N Pascual, A Figuerola, M Vinuesa, M J Rubio, F Ramasco, I. Garcia, Marta Chicot, A Pizarro, and S Navarro

Subjects
Microbiology (medical), Pharmacology, Creatinine, medicine.medical_specialty, business.industry, Septic shock, General Medicine, medicine.disease, Sepsis, chemistry.chemical_compound, Health personnel, chemistry, Chart review, Internal medicine, Statistical significance, medicine, business
Abstract

Objective In the hospital of La Princesa, the "Sepsis Code" (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it. Methods A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p Results We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines.>5.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%. Conclusions The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.

Published
2021

4. Código Sepsis: esquivando la mortalidad en un hospital terciario

Author

Méndez, Rosa, Figuerola, Angels, Chicot, Marta, Barrios, Ana, Pascual, Natalia, Ramasco, Fernando, Rodríguez, Diego, García, Íñigo, von Wernitz, Andrés, Zurita, Nelly, Semiglia, Auxiliadora, Jiménez, David, Navarro, Sara, Rubio, María José, Vinuesa, Mercedes, del Campo, Lourdes, Bautista, Azucena, and Pizarro, Alberto

Subjects
lactate, aminas, Original, sepsis code, amines, creatinine, Aftercare, creatinina, mortality, Shock, Septic, Código Sepsis, Patient Discharge, lactato, Tertiary Care Centers, Sepsis, mortalidad, Humans, Hospital Mortality, Retrospective Studies
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.

Published
2021

5. Impact of the implementation of a Sepsis Code Program in medical patient management: a cohort study in an Internal Medicine ward

Author

Azucena Bautista Hernández, Enrique de Vega-Ríos, Jorge Serrano Ballesteros, Daniel Useros Braña, Laura Cardeñoso Domingo, Angels Figuerola Tejerina, Andrés von Wernitz Teleki, David Jiménez Jiménez, Ignacio de los Santos Gil, and Carmen Sáez Béjar

Subjects
Microbiology (medical), Pharmacology, Aged, 80 and over, Cohort Studies, Sepsis, Humans, General Medicine, Length of Stay, Hospitals, Retrospective Studies
Abstract

Introduction. Sepsis is the main cause of death in hospitals and the implementation of diagnosis and treatment bundles has shown to improve its evolution. However, there is a lack of evidence about patients attended in conventional units. Methods. A 3-year retrospective cohort study was conducted. Patients hospitalized in Internal Medicine units with sepsis were included and assigned to two cohorts according to Sepsis Code (SC) activation (group A) or not (B). Baseline and evolution variables were collected. Results. A total of 653 patients were included. In 296 cases SC was activated. Mean age was 81.43 years, median Charlson comorbidity index (CCI) was 2 and 63.25% showed some functional disability. More bundles were completed in group A: blood cultures 95.2% vs 72.5% (p < 0.001), extended spectrum antibiotics 59.1% vs 41.4% (p < 0.001), fluid resuscitation 96.62% vs 80.95% (p < 0.001). Infection control at 72 hours was quite higher in group A (81.42% vs 55.18%, odds ratio 3.55 [2.48-5.09]). Antibiotic was optimized more frequently in group A (60.77% vs 47.03%, p 0.008). Mean in-hospital stay was 10.63 days (11.44 vs 8.53 days, p < 0.001). Complications during hospitalization appeared in 51.76% of patients, especially in group B (45.95% vs 56.58%, odds ratio 1.53 [1.12-2.09]). Hospital readmissions were higher in group A (40% vs 24.76%, p < 0.001). 28-day mortality was significantly lower in group A (20.95% vs 42.86%, odds ratio 0.33 [0.23-0.47]). Conclusions. Implementation of SC seems to be effective in improving short-term outcomes in IM patients, although therapy should be tailored in an individual basis.

Published
2022

6. Impact of the implementation of a Sepsis Code Program in medical patient management: a cohort study in an Internal Medicine ward

Author

Bautista Hernández, Azucena, primary, de Vega-Ríos, Enrique, additional, Serrano Ballesteros, Jorge, additional, Useros Braña, Daniel, additional, Cardeñoso Domingo, Laura, additional, Figuerola Tejerina, Angels, additional, von Wernitz Teleki, Andrés, additional, Jiménez Jiménez, David, additional, de los Santos Gil, Ignacio, additional, and Sáez Béjar, Carmen, additional

Published
2022
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7. Sepsis Code: dodging mortality in a tertiary hospital

Author

Méndez, Rosa, primary, Figuerola, Angels, additional, Chicot, Marta, additional, Barrios, Ana, additional, Pascual, Natalia, additional, Ramasco, Fernando, additional, Rodríguez, Diego, additional, García, Íñigo, additional, von Wernitz, Andrés, additional, Zurita, Nelly, additional, Semiglia, Auxiliadora, additional, Jiménez, David, additional, Navarro, Sara, additional, Rubio, María José Rubio, additional, Vinuesa, Mercedes, additional, del Campo, Lourdes, additional, Bautista, Azucena, additional, and Pizarro, Alberto, additional

Published
2021
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8. Initial clinical outcomes and prognostic variables in the implementation of a Code Sepsis in a high complexity University Hospital

Author

Ramasco, Fernando, Figuerola, Angels, Mendez, Rosa, Serrano, Diego Rodríguez, von Wernitz, Andrés, Hernández-Aceituno, Ana, Sáez, Carmen, Cardeñoso, Laura, Martin, Elena, García-Vázquez, Nieves, de las Cuevas, Carmen, Pascual, Natalia, Bautista, Azucena, Jiménez, David, Fernández, Guillermo, Leal, Ana, Vinuesa, Mercedes, Pizarro, Alberto, di Martino, Marcello, Del Campo, Lourdes, Sanz, Iñigo García, Chicot, Marta, Barrios, Ana, and Rubio, María José

Subjects
Adult, Aged, 80 and over, Male, Original, Age Factors, código sepsis, Middle Aged, Prognosis, mortality, Hospitals, University, Treatment Outcome, code sepsis, Clinical Protocols, Risk Factors, Sepsis, Creatinine, mortalidad, Humans, Female, Hospital Mortality, Lactic Acid, Procalcitonin, Biomarkers, APACHE, Aged
Abstract

Objectives 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. Materials and 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 65 years (OR 5.33, p 3 mmol/L (OR 5,85, p 1,2 mgr /dL (OR 4,54, p

Published
2019

9. Documento de consenso para la implantación y desarrollo del Código Sepsis en la Comunidad de Madrid

Author

Herrejón, Eduardo Palencia, del Castillo, Juan González, Rueda, Fernando Ramasco, González, Francisco Javier Candel, Artola, Beatriz Sánchez, Teleki, Andrés von Wernitz, Vidal, Federico Gordo, Iglesias, Patricia Roces, Redondo, Guillermina Bejarano, Serrano, Diego Aníbal Rodríguez, Reinoso, Francisco Javier Cobo, Torres, Ervigio Corral, de Gracia, Milagros Martí, and Álvarez, Ana Ruiz

Subjects
Patient Care Team, Cross Infection, Emergency Medical Services, Consensus, Evidence-Based Medicine, sepsis code, Organ Dysfunction Scores, Documento de Consenso, código sepsis, Anti-Bacterial Agents, Checklist, sepsis, Community-Acquired Infections, Norepinephrine, Early Diagnosis, Spain, Humans, Vasoconstrictor Agents, quick-SOFA (qSOFA), Emergency Treatment, consensus document, Biomarkers, Decision Making, Organizational
Abstract

RESUMEN Se presenta aquí el documento de consenso para la implantación y desarrollo del Código Sepsis en la Comunidad de Madrid, cuya redacción se completó en abril de 2017. Este documento ha sido adoptado por la Consejería de Sanidad madrileña como base de trabajo para la puesta en marcha del Código Sepsis, tanto en el ámbito hospitalario (hospitales de agudos y de media y larga estancia) como en Atención Primaria y los Servicios de Emergencia Extrahospitalaria. Se publica ahora sin modificaciones con respecto a la versión original, añadiendo únicamente las referencias bibliográficas más significativas. El documento se estructura en cuatro partes: introducción, detección y valoración iniciales, tratamiento inicial y organización asistencial. En las partes segunda a cuarta se proponen 25 recomendaciones, consensuadas por los autores después de varias reuniones presenciales y una extensa discusión “online”. Se incluyen nueve tablas que pretenden servir de guía práctica para la activación y aplicación del código sepsis. Tanto el contenido de las recomendaciones como su redacción formal se han realizado teniendo en cuenta su aplicabilidad en todos los ámbitos a los que se dirigen, que cuentan con recursos y características estructurales y funcionales muy dispares, por lo que deliberadamente se ha huido de un mayor grado de concreción: el objetivo no es que el código sepsis se organice y se aplique de forma idéntica en todos ellos, sino que los recursos sanitarios trabajen de forma coordinada alineados en la misma dirección.

Published
2019

10. IL-6 serum levels predict severity and response to Tocilizumab in COVID-19: an observational study

Author

José María Galván-Román, Sebastián C. Rodríguez-García, Emilia Roy-Vallejo, Ana Marcos-Jiménez, Santiago Sánchez-Alonso, Carlos Fernández-Díaz, Ana Alcaraz-Serna, Tamara Mateu-Albero, Pablo Rodríguez-Cortes, Ildefonso Sánchez-Cerrillo, Laura Esparcia, Pedro Martínez-Fleta, Celia López-Sanz, Ligia Gabrie, Luciana del Campo Guerola, Carmen Suárez-Fernández, Julio Ancochea, Alfonso Canabal, Patricia Albert, Diego A. Rodríguez-Serrano, Juan Mariano Aguilar, Carmen del Arco, Ignacio de los Santos, Lucio García-Fraile, Rafael de la Cámara, José María Serra, Esther Ramírez, Tamara Alonso, Pedro Landete, Joan B. Soriano, Enrique Martín-Gayo, Arturo Fraile Torres, Nelly Daniela Zurita Cruz, Rosario García-Vicuña, Laura Cardeñoso, Francisco Sánchez-Madrid, Arantzazu Alfranca, Cecilia Muñoz-Calleja, Isidoro González-Álvaro, Teresa Alvarado, Pablo Martínez, Francisco Javier de la Cuerda Llorente, Natalia Villalba, Mónica Negro, Elvira Contreras, Ana del Rey, Cristina Santiago, Manuel Junquera, Raquel Caminero, Francisco Javier Val, Sonia González, Marta Caño, Isabel López, Andrés von Wernitz, Bárbara Retana, Iñigo Guerra, Jorge Sorando, Lydia Chao, María José Cárdenas, Verónica Espiga, Pablo Chicharro, Pedro Rodríguez, Iñigo Hernando Alday, Miguel Sampedro, Jorge Prada, Eukene Rojo Aldama, Yolanda Real, María Caldas, Sergio Casabona, Aitor Lanas-Gimeno, Rafael de la Camara, Angela Figuera Alvárez, Beatriz Aguadol, Alberto Morell, Amparo Ibáñez Zurriaga, María Pérez Abanades, Silvia Ruiz García, Tomás Gallego Aranda, María Ruiz, Concepción Martínez Nieto, Javier Aspa, Elena Fernández, Ma José Calzada, Reyes Tejedor, Judit Iglesias, Fernando Suarez, Juan Antonio Sánchez, Beatriz Abad, Carmen Suarez, Emilia Roy, Jesus Sanz, Eduardo Sanchez, Fernando Moldenhauer, Pedro Casado, Jose Curbelo, Angela Gutierrez, Azucena Bautista, Nuria Ruiz Giménez, Angelica Fernandez, Pedro Parra, Berta Moyano, Ana Barrios, Diego Real de Asua, Beatriz Sanchez, Carmen Saez, Marianela Ciudad, Desiré Navas, Laura Cardeñoso Domingo, María del Carmen Cuevas Torresano, Diego Domingo García, Teresa Alarcón Cavero, Alicia García Blanco, Alexandra Martín Ramírez, María Auxiliadora Semiglia Chong, Ainhoa Gutiérrez Cobos, Arturo Manuel Fraile Torres, Carmen Sanchez-Gonzalez, Antonio Fernádez Perpén, Carolina Díaz Pérez, Joan Soriano, Carolina Cisneros, Elena García Castillo, Francisco Javier García Pérez, Rosa María Girón, Celeste Marcos, Enrique Zamora, Patricia García García, Santos Castañeda, Sebastián Rodríguez-García, Irene Llorente Cubas, Eva G. Tomero, Noelia García Castañeda, Ana Ma Ortiz, Cristina Valero, Miren Uriarte, and Nuria Montes

Subjects
0301 basic medicine, ARDS, CAR, chimeric antigen receptor, medicine.medical_treatment, Invasive Mechanical Ventilation, chemistry.chemical_compound, 0302 clinical medicine, SatO2, mean oxygen saturation, Interquartile range, Fraction of inspired oxygen, Immunology and Allergy, 030212 general & internal medicine, COVID-19, coronavirus disease 2019, PaO2/FiO2, arterial oxygen tension/fraction of inspired oxygen ratio, TNF, tumor necrosis factor, AUC, Area under curve, AEMPS, Spanish Agency for Drugs and Health Devices, Tocilizumab, CRS, cytokine release syndrome, PCT, procalcitonin, Cytokine release syndrome, CRP, C-reactive protein, LR, negative likelihood ratio, medicine.medical_specialty, Immunology, LR+, positive likelihood ratio, Article, 03 medical and health sciences, Internal medicine, medicine, TCZ, Tocilizumab, Survival rate, ARDS, acute respiratory distress syndrome, IQR, interquartile range, Mechanical ventilation, business.industry, Interleukin-6, COVID-19, Odds ratio, PaO2, arterial oxygen tension, medicine.disease, IL, interleukin, ROC, receiver operating characteristic, 030104 developmental biology, IMV, invasive mechanical ventilation, chemistry, COPD, chronic obstructive pulmonary disease, STROBE, Strengthening the Reporting of Observational Studies in Epidemiology, business, SD, standard deviation
Abstract

Background COVID-19 patients can develop a cytokine release syndrome that eventually leads to acute respiratory distress syndrome (ARDS) requiring invasive mechanical ventilation (IMV). Since interleukin-6 (IL-6) is a relevant cytokine in ARDS, the blockade of its receptor with Tocilizumab (TCZ) could reduce mortality and/or morbidity in severe COVID-19. Objective To determine whether baseline IL-6 serum levels can predict the need for IMV and the response to TCZ. Methods Retrospective observational study performed in hospitalized patients diagnosed of COVID-19. Clinical information and laboratory findings, including IL-6 levels, were collected approximately 3 and 9 days after admission to be matched with pre- and post-administration of TCZ. Multivariable logistic and linear regressions, and survival analysis were performed depending on outcomes: need for IMV, evolution of arterial oxygen tension/fraction of inspired oxygen ratio (PaO2/FiO2) or mortality. Results One hundred and forty-six patients were studied, predominantly male (66%); median age was 63 years. Forty-four patients (30%) required IMV, and 58 patients (40%) received treatment with TCZ. IL-6 levels>30 pg/ml was the best predictor for IMV (OR:7.1; p30 pg/ml predicts IMV requirement in patients with COVID-19 and contributes to establish an adequate indication for TCZ administration., Baseline IL-6 serum levels>30 pg/ml identify severe COVID-19 patients and should be used to guide the intervention with IL-6R inhibitors, aiming to improve their use in an uncertain and evolving therapeutic scenario.

Published
2020

11. [Potential biomarkers predictors of mortality in COVID-19 patients in the Emergency Department]

Author

F M Arrabal Campos, F Ramasco Rueda, I Granero Cremades, A von Wernitz Teleki, M A Sanz de Benito, A. Figuerola Tejerina, I Monge Lobo, and N F Pascual Gómez

Subjects
Microbiology (medical), Blood Glucose, Male, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), Original, Pneumonia, Viral, Renal function, escala de riesgo, 030204 cardiovascular system & hematology, Risk Assessment, Sensitivity and Specificity, 03 medical and health sciences, Betacoronavirus, Leukocyte Count, 0302 clinical medicine, Pcr test, Predictive Value of Tests, medicine, Odds Ratio, Humans, score, Clinical severity, 030212 general & internal medicine, Pandemics, Aged, Retrospective Studies, COVID, Pharmacology, Gynecology, Analysis of Variance, business.industry, Reverse Transcriptase Polymerase Chain Reaction, SARS-CoV-2, emergency, Age Factors, COVID-19, General Medicine, Cross-Sectional Studies, Area Under Curve, Creatinine, Hypertension, Female, urgencias, business, Coronavirus Infections, Emergency Service, Hospital, Biomarkers
Abstract

espanolObjetivo. Identificar que biomarcadores realizados en la primera analitica de urgencias ayudan a estratificar segun riesgo de mortalidad a pacientes COVID 19. Metodo. Estudio observacional descriptivo y transversal realizado con datos recogidos de los pacientes con sospecha de COVID-19 en el Servicio de Urgencias del 24 de febrero al 16 de marzo del 2020. Se realizo el estudio univariante y multivariante para encontrar los marcadores independientes de mortalidad y calcular el riesgo mediante la construccion de una escala de gravedad. Resultados. Se incluyeron 163 pacientes de los que fallecieron 33 y 29 de ellos resultaron positivos para la prueba PCR COVID-19. Obtuvimos como posibles factores para conformar el score de riesgo de mortalidad edad>75 anos ((OR ajustada=12,347, IC95%: 4,138-36,845 p=0.001), leucocitos totales> 11.000 cel/mm3 (OR ajustada=2,649, IC95%: 0,879-7,981 p=0,083), glucosa> 126 mg/dL (OR ajustada=3,716, IC95%: 1,247-11,074 p=0,018) y creatinina>1,1 mg/dL (OR ajustada= 2,566, IC95%: 0,889-7,403, p=0,081). Este score se denomino COVEB (COVID, Edad, perfil Basico analitico) con un AUC 0,874 (IC95%: 0,816-0,933, p Conclusiones. Las escalas clinicas de gravedad, los biomarcadores de funcion renal, los parametros del recuento leucocitario, el ratio neutrofilos totales/linfocitos y procalcitonina son factores de riesgo tempranos de mortalidad. Destacan las variables edad, glucosa, creatinina y leucocitos totales como mejores predictores de mortalidad. Un score COVEB EnglishObjective. Identify which biomarkers performed in the first emergency analysis help to stratify COVID-19 patients according to mortality risk. Method. Observational, descriptive and cross-sectional study performed with data collected from patients with suspected COVID-19 in the Emergency Department from February 24 to March 16, 2020. The univariate and multivariate study was performed to find independent mortality markers and calculate risk by building a severity score. Results. A total of 163 patients were included, of whom 33 died and 29 of them were positive for the COVID-19 PCR test. We obtained as possible factors to conform the Mortality Risk Score age> 75 years ((adjusted OR = 12,347, 95% CI: 4,138-36,845 p = 0.001), total leukocytes> 11,000 cells / mm3 (adjusted OR = 2,649, 95% CI: 0.879-7.981 p = 0.083), glucose> 126 mg / dL (adjusted OR = 3.716, 95% CI: 1.247- 11.074 p = 0.018) and creatinine> 1.1 mg / dL (adjusted OR = 2.566, 95% CI: 0.889- 7.403, p = 0.081) This score was called COVEB (COVID, Age, Basic analytical profile) with an AUC 0.874 (95% CI: 0.816-0.933, p Conclusions. Clinical severity scales, kidney function biomarkers, white blood cell count parameters, the total neutrophils / total lymphocytes ratio and procalcitonin are early risk factors for mortality. The variables age, glucose, creatinine and total leukocytes stand out as the best predictors of mortality. A COVEB score

Published
2020

12. Acute polyradiculoneuritis with locked-in syndrome in a patient with Covid-19

Author

Thomas Pfefferkorn, Thomas von Wernitz-Keibel, Martina Nowak-Machen, Hendrik Janssen, Rainer Dabitz, and Johannes Aufenanger

Subjects
2019-20 coronavirus outbreak, biology, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Clinical Neurology, medicine.disease, biology.organism_classification, Letter to the Editors, Virology, Pneumonia, Neurology, Pandemic, medicine, Neurology (clinical), Locked-in syndrome, business, Betacoronavirus, Neuroradiology
Abstract

In this case report we present a patient from Germany who developed a severe GBS in the course of Covid-19.

Published
2020
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13. IL-6 serum levels predict severity and response to tocilizumab in COVID-19: An observational study

Author

Galván-Román, José María, primary, Rodríguez-García, Sebastián C., additional, Roy-Vallejo, Emilia, additional, Marcos-Jiménez, Ana, additional, Sánchez-Alonso, Santiago, additional, Fernández-Díaz, Carlos, additional, Alcaraz-Serna, Ana, additional, Mateu-Albero, Tamara, additional, Rodríguez-Cortes, Pablo, additional, Sánchez-Cerrillo, Ildefonso, additional, Esparcia, Laura, additional, Martínez-Fleta, Pedro, additional, López-Sanz, Celia, additional, Gabrie, Ligia, additional, del Campo Guerola, Luciana, additional, Suárez-Fernández, Carmen, additional, Ancochea, Julio, additional, Canabal, Alfonso, additional, Albert, Patricia, additional, Rodríguez-Serrano, Diego A., additional, Aguilar, Juan Mariano, additional, del Arco, Carmen, additional, de los Santos, Ignacio, additional, García-Fraile, Lucio, additional, de la Cámara, Rafael, additional, Serra, José María, additional, Ramírez, Esther, additional, Alonso, Tamara, additional, Landete, Pedro, additional, Soriano, Joan B., additional, Martín-Gayo, Enrique, additional, Fraile Torres, Arturo, additional, Zurita Cruz, Nelly Daniela, additional, García-Vicuña, Rosario, additional, Cardeñoso, Laura, additional, Sánchez-Madrid, Francisco, additional, Alfranca, Arantzazu, additional, Muñoz-Calleja, Cecilia, additional, González-Álvaro, Isidoro, additional, Alvarado, Teresa, additional, Martínez, Pablo, additional, Javier de la Cuerda Llorente, Francisco, additional, Arco, Carmen del, additional, Villalba, Natalia, additional, Negro, Mónica, additional, Contreras, Elvira, additional, Rey, Ana del, additional, Santiago, Cristina, additional, Junquera, Manuel, additional, Caminero, Raquel, additional, Val, Francisco Javier, additional, González, Sonia, additional, Caño, Marta, additional, López, Isabel, additional, von Wernitz, Andrés, additional, Retana, Bárbara, additional, Guerra, Iñigo, additional, Sorando, Jorge, additional, Chao, Lydia, additional, Cárdenas, María José, additional, Espiga, Verónica, additional, Chicharro, Pablo, additional, Rodríguez, Pedro, additional, Alday, Iñigo Hernando, additional, Sampedro, Miguel, additional, Prada, Jorge, additional, Aldama, Eukene Rojo, additional, Real, Yolanda, additional, Caldas, María, additional, Casabona, Sergio, additional, Lanas-Gimeno, Aitor, additional, Camara, Rafael de la, additional, Alvárez, Angela Figuera, additional, Aguadol, Beatriz, additional, Morell, Alberto, additional, Zurriaga, Amparo Ibáñez, additional, Abanades, María Pérez, additional, García, Silvia Ruiz, additional, Aranda, Tomás Gallego, additional, Ruiz, María, additional, Nieto, Concepción Martínez, additional, Aspa, Javier, additional, Guerola, Luciana del Campo, additional, Fernández, Elena, additional, Calzada, Ma José, additional, Tejedor, Reyes, additional, Iglesias, Judit, additional, Suarez, Fernando, additional, Sánchez, Juan Antonio, additional, Abad, Beatriz, additional, Suarez, Carmen, additional, Santos, Ignacio de los, additional, Galván-Román, José María, additional, Roy, Emilia, additional, Sanz, Jesus, additional, Sanchez, Eduardo, additional, Moldenhauer, Fernando, additional, Casado, Pedro, additional, Curbelo, Jose, additional, Gutierrez, Angela, additional, Bautista, Azucena, additional, Giménez, Nuria Ruiz, additional, Fernandez, Angelica, additional, Parra, Pedro, additional, Moyano, Berta, additional, Barrios, Ana, additional, Real de Asua, Diego, additional, Sanchez, Beatriz, additional, Saez, Carmen, additional, Ciudad, Marianela, additional, Navas, Desiré, additional, Domingo, Laura Cardeñoso, additional, Torresano, María del Carmen Cuevas, additional, García, Diego Domingo, additional, Cavero, Teresa Alarcón, additional, Blanco, Alicia García, additional, Ramírez, Alexandra Martín, additional, Semiglia Chong, María Auxiliadora, additional, Cobos, Ainhoa Gutiérrez, additional, Fraile Torres, Arturo Manuel, additional, Sanchez-Gonzalez, Carmen, additional, Perpén, Antonio Fernádez, additional, Pérez, Carolina Díaz, additional, Soriano, Joan, additional, Cisneros, Carolina, additional, Castillo, Elena García, additional, García Pérez, Francisco Javier, additional, Girón, Rosa María, additional, Marcos, Celeste, additional, Zamora, Enrique, additional, García, Patricia García, additional, Castañeda, Santos, additional, Rodríguez-García, Sebastián, additional, Cubas, Irene Llorente, additional, Tomero, Eva G., additional, Castañeda, Noelia García, additional, Ortiz, Ana Ma, additional, Valero, Cristina, additional, Uriarte, Miren, additional, and Montes, Nuria, additional

Published
2021
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14. Código Sepsis: esquivando la mortalidad en un hospital terciario.

Author

Méndez, Rosa, Figuerola, Angels, Chicot, Marta, Barrios, Ana, Pascual, Natalia, Ramasco, Fernando, Rodríguez, Diego, García, Íñigo, von Wernitz, Andrés, Zurita, Nelly, Semiglia, Auxiliadora, Jiménez, David, Navarro, Sara, José Rubio, María, Vinuesa, Mercedes, del Campo, Lourdes, Bautista, Azucena, and Pizarro, Alberto

Abstract

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2022
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15. Comparison of different strategies for short-term death prediction in the infected older patient

Author

Yanez M, Mota M, Ferrer M, Julian-Jimenez A, Pinera P, Llopis F, del Rio J, de Zarate M, Estella A, Martin-Sanchez F, del Castillo J, Puente P, Diaz R, Olmeda D, Izquierdo R, Nicolas J, Hurtado A, Vegas C, Bautista J, Candel F, Echebarria B, Roman F, Llorens P, Perales R, Onate J, Ordonez B, Fragero E, Ortega M, Burillo G, Hernandez C, Arranz M, Juarez R, Amez J, Muro E, Ordono L, Criado J, von Wernitz A, del Arco C, Yglesias P, Ruiz F, Castrillo L, Alonso H, Salido M, Miranda B, Grinspan M, Tey J, Mateo S, Roca M, Ezponda F, Diez E, Garcia F, Huarte I, Martin S, Moreno M, de Sosa S, de la Chica A, Losa C, Navarro R, Vela M, Gilmartin L, Martinez C, Rodriguez V, Rodriguez M, Marti A, Beliz O, Quesada S, Ungerer O, Rodriguez T, Irigoyen L, Andonegui C, Cortes N, Gamito G, Borrego B, Betegon M, Moreno A, Borras M, Gamaury A, Quevedo J, Munoz V, Tejada C, Menchaca B, Deltell J, Lopez A, Lecinera M, Moreto S, Mendez C, Fernandez S, Rodriguez R, Aljama M, Rivas M, Amador L, Munoz J, Carrasco E, Salazar D, Orantos M, Adrada E, and Grp Infecciones Soc Espanola Med

Subjects
sepsis, qSOFA, emergency, SIRS, infected older patient, prognosis, mortality
Abstract

Objective. The aim of this study was to determine the utility of a post hoc lactate added to SIRS and qSOFA score to predict 30-day mortality in older non-severely dependent patients attended for infection in the Emergency Department (ED). Methods. We performed an analytical, observational, prospective cohort study including patients of 75 years of age or older, without severe functional dependence, attended for an infectious disease in 69 Spanish ED for 2-day three seasonal periods. Demographic, clinical and analytical data were collected. The primary outcome was 30-day mortality after the index event. Results. We included 739 patients with a mean age of 84.9 (SD 6.0) years; 375 (50.7%) were women. Ninety-one (12.3%) died within 30 days. The AUC was 0.637 (IC 95% 0.587-0.688; p= 2 and 0.698 (IC 95% 0.635- 0.761; p= 2. Comparing receiver operating characteristic (ROC) there was a better accuracy of qSOFA vs SIRS (p=0.041). Both scales improve the prognosis accuracy with lactate inclusion. The AUC was 0.705 (IC95% 0.652-0.758; p

Published
2019

16. Comparación de distintas estrategias para la predicción de muerte a corto plazo en el paciente anciano infectado

Author

Yanez, M.C, Mota, M.S, Ferrer, M.F, Julian-Jimenez, A, Pinera, P, Llopis, F, del Rio, J.G, de Zarate, M.M.O, Estella, A, Martin-Sanchez, F.J, del Castillo, J.G, Puente, P.H, Diaz, R.R, Olmeda, D.M, Izquierdo, R.L, Nicolas, J.A.S, Hurtado, A.A.A, Vegas, C.D, Bautista, J.G, Candel, F.J, Echebarria, B.C, Roman, F, Llorens, P, Perales, R, Onate, J, Ordonez, B.M, Fragero, E, Ortega, M, Burillo, G, Hernandez, C.G, Arranz, M.J, Juarez, R, Amez, J.M.F, Muro, E, Ordono, L.P, Criado, J.G, von Wernitz, A, del Arco, C, Yglesias, P.J.M, Ruiz, F, Castrillo, L.G, Alonso, H, Salido, M, Miranda, B.R, Grinspan, M.R, Tey, J.M.G, Mateo, S.H, Roca, M.M, Ezponda, F.J, Diez, E, Garcia, F.G, Huarte, I, Martin, S.G, Moreno, M.C, de Sosa, S.J, de la Chica, A, Losa, C.F, Navarro, R.D, Vela, M.I, Gilmartin, L.M.M, Martinez, C.A, Rodriguez, V.A, Rodriguez, M.F, Marti, A.M.G, Beliz, O.J.S, Quesada, S.F, Ungerer, O.T, Rodriguez, T.C, Irigoyen, L.L, Andonegui, C, Cortes, N, Gamito, G.M, Borrego, B.V, Betegon, M.A, Moreno, A.S, Borras, M.R.C, Gamaury, A.U, Quevedo, J.C, Munoz, V.C, Tejada, C.M, Menchaca, B, Deltell, J.M.M, Lopez, A.M, Lecinera, M.A, Moreto, S.S, Mendez, C.S, Fernandez, S.P, Rodriguez, R, Aljama, M.A.C, Rivas, M.F, Amador, L, Munoz, J.E.C, Carrasco, E, Salazar, D.R, Orantos, M.J.N, and Adrada, E.R.

Abstract

Objective. The aim of this study was to determine the utility of a post hoc lactate added to SIRS and qSOFA score to predict 30-day mortality in older non-severely dependent patients attended for infection in the Emergency Department (ED). Methods. We performed an analytical, observational, prospective cohort study including patients of 75 years of age or older, without severe functional dependence, attended for an infectious disease in 69 Spanish ED for 2-day three seasonal periods. Demographic, clinical and analytical data were collected. The primary outcome was 30-day mortality after the index event. Results. We included 739 patients with a mean age of 84.9 (SD 6.0) years; 375 (50.7%) were women. Ninety-one (12.3%) died within 30 days. The AUC was 0.637 (IC 95% 0.587-0.688; p= 2 and 0.698 (IC 95% 0.635- 0.761; p= 2. Comparing receiver operating characteristic (ROC) there was a better accuracy of qSOFA vs SIRS (p=0.041). Both scales improve the prognosis accuracy with lactate inclusion. The AUC was 0.705 (IC95% 0.652-0.758; p

Published
2019

17. Recovery of a 10-year-old girl from methicillin-resistant Staphylococcus aureus sepsis in response to low-dose ceftaroline treatment

Author

Beate Rieß, Franziska Layer, Thomas von Wernitz-Keibel, Matthias Bühler, Stefan Borgmann, and Birgit Strommenger

Subjects
0301 basic medicine, medicine.medical_specialty, Low dosage, medicine.medical_treatment, media_common.quotation_subject, 030106 microbiology, Case Report, minimal inhibitory concentration, medicine.disease_cause, susceptibility, Sepsis, 03 medical and health sciences, Minimum inhibitory concentration, Internal medicine, medicine, Pharmacology (medical), Girl, General Pharmacology, Toxicology and Pharmaceutics, media_common, therapy, Chemical Health and Safety, business.industry, Low dose, General Medicine, medicine.disease, Methicillin-resistant Staphylococcus aureus, Surgery, side effects, Amputation, Staphylococcus aureus, ceftaroline, business, Safety Research
Abstract

A 9-year-old girl was severely injured in a car accident in Afghanistan, in which both her lower legs were badly damaged. She was treated at the Hospital of Ingolstadt (Klinikum Ingolstadt) after she had undergone initial surgery at an Indian hospital. Various bacterial species were isolated from multiple wounds, and methicillin-resistant Staphylococcus aureus (MRSA) was one among them. After the amputation of her lower legs, she developed MRSA sepsis, which was successfully treated with a relatively low dosage of ceftaroline (Zinforo®/Teflaro®; 2×9 mg/kg/d), although the bacterial isolate’s minimal inhibitory concentration (1.5–4 mg/L) suggested a decreased susceptibility. In summary, ceftaroline was highly efficient and well tolerated by the patient suffering from MRSA sepsis., Video abstract

Published
2016

18. Potenciales biomarcadores predictores de mortalidad en pacientes COVID-19 en el Servicio de Urgencias.

Author

Pascual Gómez, Natalia F., Monge Lobo, Iván, Granero Cremades, Inmaculada, Figuerola Tejerina, Angels, Ramasco Rueda, Fernando, von Wernitz Teleki, Andrés, Arrabal Campos, Francisco Manuel, and Sanz de Benito, M. Ángeles

Abstract

Copyright of Revista Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2020
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20. [Sepsis Code: dodging mortality in a tertiary hospital].

Author

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, and Pizarro A

Subjects
Aftercare, Hospital Mortality, Humans, Patient Discharge, Retrospective Studies, Tertiary Care Centers, Sepsis, Shock, Septic
Abstract

Objective: In the hospital of La Princesa, the "Sepsis Code" (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it., Methods: A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05., Results: We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines.>5.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%., Conclusions: The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis., (©The Author 2021. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https://creativecommons.org/licenses/by-nc/4.0/).)

Published
2022
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