AHRQ, Author Interviews, Infections, University of Pennsylvania / 15.10.2014

Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center University of Pennsylvania, Philadelphia, PA 19104MedicalResearch.com Interview with: Craig A Umscheid, MD, MSCE, FACP Assistant Professor of Medicine and Epidemiology Director, Center for Evidence-based Practice Medical Director, Clinical Decision Support Chair, Department of Medicine Quality Committee Senior Associate Director, ECRI-Penn AHRQ Evidence-based Practice Center, University of Pennsylvania Philadelphia, PA 19104 Medical Research: What are the main findings of the study? Dr. Umscheid: We developed an automated early warning and response system for sepsis that has resulted in a marked increase in sepsis identification and care, transfer to the ICU, and an indication of fewer deaths due to sepsis. Sepsis is a potentially life-threatening complication of an infection; it can severely impair the body’s organs, causing them to fail. There are as many as three million cases of severe sepsis and 750,000 resulting deaths in the United States annually. Early detection and treatment, typically with antibiotics and intravenous fluids, is critical for survival. The Penn prediction tool, dubbed the “sepsis sniffer,” uses laboratory and vital-sign data (such as body temperature, heart rate, and blood pressure) in the electronic health record of hospital inpatients to identify those at risk for sepsis. When certain data thresholds are detected, the system automatically sends an electronic communication to physicians, nurses, and other members of a rapid response team who quickly perform a bedside evaluation and take action to stabilize or transfer the patient to the intensive care unit if warranted. We developed the prediction tool using 4,575 patients admitted to the University of Pennsylvania Health System (UPHS) in October 2011.  We then validated the tool during a pre-implementation period from June to September 2012, when data on admitted patients was evaluated and alerts triggered in a database, but no notifications were sent to providers on the ground.  Outcomes in that control period were then compared to a post-implementation period from June to September 2013.  The total number of patients included in the pre and post periods was 31,093.
Author Interviews, Infections, NEJM / 08.10.2014

Anders Perner, MD, PhD Overlæge / Senior staff specialist Professor / Professor in Intensive Care Dept of Intensive Care Rigshospitalet Copenhagen DenmarkMedicalResearch.com Interview with: Anders Perner, MD, PhD Overlæge / Senior staff specialist Professor / Professor in Intensive Care Dept of Intensive Care Rigshospitalet Copenhagen Denmark Medical Research: What are the main findings of the study? Dr. Perner: In the large international randomised trial, we showed similar outcomes in patients with septic shock with anemia transfused at a lower vs. a higher hemoglobin threshold. The lower threshold group received 50 % fewer transfusions and one-third of these patients were never transfused in ICU.
Author Interviews, Brigham & Women's - Harvard, Nature / 15.09.2014

MedicalResearch.com Interview with: MichDr. Michael Super, Ph.D.ael Super M.Sc., PhD Senior Staff Scientist Advanced Technology Team Wyss Institute at Harvard Center for Life Science, 2nd Floor Boston MA 02115 Medical Research: What is the background for this study? How big a problem is sepsis? Dr. Super:
  • Sepsis is a major problem and is the primary cause of death from infection. The incidence of sepsis is rising.
  • Sepsis affects more than 18 M people each year and at least 1/3 ( 6 million) die every year of sepsis.
  • Sepsis is a disease that affects the very young and old and it is estimated that 60-80% of childhood deaths in the developing world are due to sepsis.
Author Interviews, Critical Care - Intensive Care - ICUs, NEJM, Statins / 22.05.2014

Jonathon D. Truwit, MD, MBA Enterprise Chief Medical Officer Sr. Administrative Dean Froedtert-Medical College of Wisconsin Milwaukee, WI 53226MedicalResearch.com Interview with: Jonathon D. Truwit, MD, MBA Enterprise Chief Medical Officer Sr. Administrative Dean Froedtert-Medical College of Wisconsin Milwaukee, WI 53226 MedicalResearch.com: What are the main findings of the study? Dr. Truwit: Rosuvastatin did not reduce mortality, nor days free of the breathing machine, in patients with sepsis-associated acute respiratory distress syndrome (ARDS). One in four patients with ARDS die.