Effect of COVID-19 Pandemic Restructuring on Surgical Volume and Outcomes of Non-COVID Patients Undergoing Surgery

Objectives COVID-19 has caused significant surgical delays as institutions minimize patient exposure to hospital settings and utilization of health care resources. We aimed to assess changes in surgical case mix and outcomes due to restructuring during the pandemic. Methods Patients undergoing surgery at a single tertiary care institution in the Deep South were identified using institutional ACS-NSQIP data. Primary outcome was case mix. Secondary outcomes were post-operative complications. Chi-square, ANOVA, logistic regression, and linear regression were used to compare the control (pre-COVID, Mar 2018-Mar 2020) and case (during COVID, Mar 2020-Mar 2021) groups. Results Overall, there were 6912 patients (control: 4,800 and case: 2112). Patients were 70% white, 29% black, 60% female, and 39% privately insured. Mean BMI was 30.2 (SD = 7.7) with mean age of 58.3 years (SD = 14.8). Most surgeries were with general surgery (48%), inpatient (68%), and elective (83%). On multivariable logistic regression, patients undergoing surgery during the pandemic were more likely to be male (OR: 1.14) and in SIRS (OR: 2.07) or sepsis (OR: 2.28) at the time of surgery. Patients were less likely to have dyspnea with moderate exertion (OR: .75) and were less dependent on others (partially dependent OR: .49 and totally dependent OR: .15). Surgeries were more likely to be outpatient (OR: 1.15) and with neurosurgery (OR: 1.19). On bivariate analysis, there were no differences in post-operative outcomes. Conclusion Surgeries during the COVID-19 pandemic were more often outpatient without differences in post-operative outcomes. Additional analysis is needed to determine the impact of duration of operative delay on surgical outcomes with restructuring focusing more on outpatient surgeries.

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The impact of COVID-19 related national lockdown on ophthalmic emergency in Italy: A multicenter study

European Journal of Ophthalmology ◽

10.1177/11206721211028046 ◽

2021 ◽

pp. 112067212110280

Author(s):

Maria L Salvetat ◽

Carlo Salati ◽

Patrizia Busatto ◽

Marco Zeppieri

Keyword(s):

Gender Bias ◽

Tertiary Care ◽

Lower Number ◽

Electronic Records ◽

Chi Square ◽

Efficient Access ◽

Chi Square Test ◽

Unpaired Student ◽

The Impact ◽

Wet Amd

Purpose: To assess ocular pathologies admitted to Italian Emergency Eye Departments (EEDs) during the COVID-19 pandemic national lockdown in 2020 in comparison with the same period in 2019. Methods: Electronic records of all patients presenting at EEDs of two tertiary-care Eye Centers during the COVID-19 national lockdown in Italy (March 10–May 3, 2020) were compared with the equivalent period in 2019. Main outcomes were patient age, gender, and diagnoses. Statistical analysis included unpaired Student t-tests, Poisson regression, and chi-square test. Results: Overall EED visits significantly decreased by 54.1% during the 2020 lockdown compared to 2019 (851 vs 1854, p < 0.001). During lockdown, patients showed comparable mean age (52.8 years in 2020 vs 53.3 years in 2019, p = 0.52) and significant male gender bias (61.1% in 2020 vs 55.8% in 2019, p < 0.0001). The most frequent pathologies were eye inflammations, trauma-related incidents, and spontaneous acute vitreous detachment. Patients with inflammation, headache/hemicrania, and spontaneous subconjunctival hemorrhages were significantly less, whereas those with trauma-related diagnoses were significantly higher during the lockdown as compared with 2019 ( p < 0.05). The proportion of non-urgent visits decreased from 17% in 2019 to 8% in 2020 ( p < 0.001). Conclusions: During the 2020 lockdown, there was a significant reduction of accesses to EED, especially for non-urgent pathologies. Potentially visual function threatening conditions, such as trauma-related pathologies, retinal detachment or ruptures, and wet AMD, showed lower number of cases but higher or stable proportion relative to the total caseload, suggesting a correct and efficient access to ophthalmic health care during the pandemic period.

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EPID-34. THE DETRIMENTAL EFFECT OF BIOPSY PRECEDING RESECTION IN SURGICALLY ACCESSIBLE GLIOBLASTOMAS: RESULTS FROM THE NATIONAL CANCER DATABASE

Neuro-Oncology ◽

10.1093/neuonc/noaa215.352 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii85-ii86

Author(s):

Ping Zhu ◽

Xianglin Du ◽

Angel Blanco ◽

Leomar Y Ballester ◽

Nitin Tandon ◽

...

Keyword(s):

Logistic Regression ◽

Failure Time ◽

Binary Logistic Regression ◽

Rank Test ◽

Imaging Features ◽

National Cancer Database ◽

Prolonged Length ◽

Logistic Regression Models ◽

Operative Outcomes ◽

The Impact

Abstract OBJECTIVES To investigate the impact of biopsy preceding resection compared to upfront resection in glioblastoma overall survival (OS) and post-operative outcomes using the National Cancer Database (NCDB). METHODS A total of 17,334 GBM patients diagnosed between 2010 and 2014 were derived from the NCDB. Patients were categorized into two groups: “upfront resection” versus “biopsy followed by resection”. Primary outcome was OS. Post-operative outcomes including 30-day readmission/mortality, 90-day mortality, and prolonged length of inpatient hospital stay (LOS) were secondary endpoints. Kaplan-Meier methods and accelerated failure time (AFT) models with gamma distribution were applied for survival analysis. Multivariable binary logistic regression models were performed to compare differences in the post-operative outcomes between these groups. RESULTS Patients undergoing “upfront resection” experienced superior survival compared to those undergoing “biopsy followed by resection” (median OS: 12.4 versus 11.1 months, log-rank test: P=0.001). In multivariable AFT models, significant survival benefits were observed among patients undergoing “upfront resection” (time ratio [TR]: 0.83, 95% CI: 0.75–0.93, P=0.001). Patients undergoing upfront GTR had the longest survival compared to upfront STR, GTR following STR, or GTR and STR following an initial biopsy (14.4 vs. 10.3, 13.5, 13.3, and 9.1, months), respectively (TR: 1.00 [Ref.], 0.75, 0.82, 0.88, and 0.67). Recent years of diagnosis, higher income and treatment at academic facilities were significantly associated with the likelihood of undergoing upfront resection after adjusting the covariates. Multivariable logistic regression revealed that 30-day mortality and 90-day mortality were decreased by 73% and 44% for patients undergoing “upfront resection” over “biopsy followed by resection”, respectively (both p < 0.001). CONCLUSIONS Pre-operative biopsies for surgically accessible tumors with characteristic imaging features of Glioblastoma lead to worse survival despite subsequent resection compared to patients undergoing upfront resection.

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Abstract P122: The Impact of Center Certification Status on Acute Stroke Care Within a Multi-Hospital System in Western United States

Stroke ◽

10.1161/str.52.suppl_1.p122 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Radoslav I Raychev ◽

CrystalAnn Moreno ◽

Leslie Corless ◽

Jason W Tarpley ◽

John F Zurasky ◽

...

Keyword(s):

Logistic Regression ◽

Clinical Outcome ◽

Regression Models ◽

Process Of Care ◽

Chi Square ◽

Hospital System ◽

Logistic Regression Models ◽

Stroke Center ◽

The Impact ◽

Iv Tpa

Introduction: We aimed to investigate the impact of certification status on process of care metrics and clinical outcome in a large multi-center hospital system. Methods: We analyzed data obtained from the Providence Stroke Registry between January 2016 and December 2019. Key process of care metrics and clinical outcome were compared among patients with a discharge diagnosis of stroke and stratified based on site certification: comprehensive stroke center (CSC), thrombectomy-capable stroke center (TSC), primary stroke center (PSC) and no certification (NC). Donner’s adjusted chi-square tests were used to compare proportions for each metric grouped by certification. Generalized linear mixed effects logistic regression models were used to adjust for mode of patient arrival, age, sex, admit NIHSS, and medical history. Results: Data included 45,278 patients. Results from the analyses are summarized in the table. Donner’s adjusted chi-square analyses showed significant differences for metrics across certification groups. Results from the logistic regression models indicated significant differences in IV TPA and EVT treatment, as well as IV TPA treatment times across certification groups. There were no significant differences between TSC and CSC. Conclusions: Patients presenting with acute ischemic stroke at NC and PSC were significantly less likely to receive IV TPA or EVT with significantly less efficient IV tPA treatment times as compared to CSC. However, CSC and TSC sites performed similarly.

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Abstract 12820: Beta Blocker Use and Peri-operative Outcomes in Cancer Patients Receiving Immunotherapy

Circulation ◽

10.1161/circ.142.suppl_3.12820 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Ohad Oren ◽

Julian R Molina ◽

Eric H Yang ◽

Michal Oren ◽

Kent Bailey ◽

...

Keyword(s):

Mortality Rate ◽

Cancer Patients ◽

Surgical Procedures ◽

Beta Blocker ◽

Wound Repair ◽

Beta Blockers ◽

Chi Square ◽

Risk Of Death ◽

Operative Outcomes ◽

The Impact

Introduction: The impact of beta blocker use on surgical outcomes of cancer patients receiving immunotherapy is unknown. Hypothesis: Beta blocker use is associated with lower post-operative mortality in cancer patients on immunotherapy. Methods: We used an institutional Advanced Cohort Explorer to identify all patients who underwent any surgical procedure less than 90 days after receiving immunotherapy. Data on the procedure performed as well as the post-operative outcome were collected and analyzed per the pre-operative beta blocker use status. Results: A total of 233 patients underwent surgery between 09/2011-06/2019. Mean age was 64.7 years (range: 16-92). The most common cancer diagnoses were lung (48, 44.4%), melanoma (49, 45.4%) and kidney (11, 10.2%). Immunotherapy medications were pembrolizumab ( 127, 54.5%), nivolumab (51, 21.9%), ipilimumab (43, 18.5%), atezolizumab (11, 4.7%) and avelumab (1, 0.43%). Pre-operative beta blocker use was documented in 140 (60.1%) patients. Most common surgical procedures were skin resection (75, 32.1%), wound repair (47, 20.2%), vascular procedures (36, 15.5%), urethral procedures 16 (6.9%) and sentinel lymph node biopsies (10, 4.3%). The 30-day mortality rate was 10.3% (24 deaths). In a multi-variable logistic regression analysis, pre-operative use of beta blockers was associated with a lower risk of death within 30 days from surgery (OR 0.34, CI 0.13-0.87, P=0.024). 30-day mortality rates were higher in patients undergoing vascular (50%, 17 of 34) versus non-vascular (3.5%, 7 of 199) procedures (P<0.0001) in a Chi Square test. Conclusions: Beta blocker use is associated with a lower 30-day mortality rate after surgical procedures in cancer patients treated with immunotherapy. Further investigation is warranted.

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Correlation of Hormonal Profile and Lipid Levels with Female Adult Acne in a Tertiary Care Center of Nepal

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v16i2.20315 ◽

2018 ◽

Vol 16 (2) ◽

pp. 222-227 ◽

Cited By ~ 2

Author(s):

Smriti Shrestha

Keyword(s):

Lipid Profile ◽

Clinical Symptoms ◽

Care Center ◽

Tertiary Care ◽

Thyroid Stimulating Hormone ◽

Bivariate Analysis ◽

Female Adult ◽

Chi Square ◽

Chi Square Test ◽

Relationship Of

Background: Acne beyond 25 years of age is frequently associated with hormonal derangement in women. Hormonal association provides the impetus for hormonal therapy as well as underpins the need for blood investigations in this population. Hence, we aim to estimate the presence of hormonal derangement and lipid alteration in female adult acne.Methods: A prospective, observational study was conducted in Dhulikhel Hospital from July 2015 to February 2016. Females older than 25 years with acne were taken in the study after informed consent. Total 100 patients were enrolled aftersample sizeestimation. Hormonal paneland lipid profile were measured. Hormones tested were androgens, C-peptide and thyroid stimulating hormone. Data analysis was done with SPSS-23. Bivariate analysis was done by chi-square test for categorical data.Results: In this study, majority of patients were younger than 30 years (70.5%) and perioral area most commonly involved. Hormonal alteration was seen in 37.2% patients, among which 17.9% had hyperandrogenism, 15.4% had abnormal thyroid level and 10.3% had high C-peptides respectively. Lipid profile was altered in 15.4% patients. Hormonal alteration had significant association with irregular menstruation (P<0.05) but not acne severity.Conclusions: We observed hormonal alteration frequently in females with adult acne, which comprised of various hormonal parameters including hyperandrogenism. Hormonal alteration reflects deranged metabolic milieu and we suggestthat wide hormonal panel should be done in female adult acne. Relationship of hormones with menstrual irregularity but not with acne severity, suggest that clinical symptoms should lead hormonal investigations in all grades of acne.

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Predicting field-goal success according to offensive, defensive and contextual variables in elite men’s wheelchair basketball

PLoS ONE ◽

10.1371/journal.pone.0244257 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244257

Author(s):

John W. Francis ◽

Alun J. Owen ◽

Derek M. Peters

Keyword(s):

Logistic Regression ◽

Performance Analysis ◽

Area Under The Curve ◽

Binary Logistic Regression ◽

Potential Effect ◽

Contextual Variables ◽

Wheelchair Basketball ◽

Chi Square ◽

Context Variable ◽

The Impact

The purposes of this study were to (i) develop a field-goal shooting performance analysis template and (ii) explore the impact of each identified variable upon the likely outcome of a field-goal attempt using binary logistic regression modelling in elite men’s wheelchair basketball. First, a field-goal shooting performance analysis template was developed that included 71 Action Variables (AV) grouped within 22 Categorical Predictor Variables (CPV) representing offensive, defensive and game context variables. Second, footage of all 5,105 field-goal attempts from 12 teams during the men’s 2016 Rio De Janeiro Paralympic Games wheelchair basketball competition were analysed using the template. Pearson’s chi-square analyses found that 18 of the CPV were significantly associated with field-goal attempt outcome (p < 0.05), with seven of them reaching moderate association (Cramer’s V: 0.1–0.3). Third, using 70% of the dataset (3,574 field-goal attempts), binary logistic regression analyses identified that five offensive variables (classification category of the player, the action leading up to the field-goal attempt, the time left on the clock, the location of the shot, and the movement of the player), two defensive variables (the pressure being exerted by the defence, and the number of defenders within a 1-meter radius) and 1 context variable (the finishing position of the team in the competition) affected the probability of a successful field-goal attempt. The quality of the developed model was determined acceptable (greater than 65%), producing an area under the curve value of 68.5% when the model was run against the remaining 30% of the dataset (1,531 field-goal attempts). The development of the model from such a large sample of objective data is unique. As such it offers robust empirical evidence to enable coaches, performance analysts and players to move beyond anecdote, in order to appreciate the potential effect of various and varying offensive, defensive and contextual variables on field-goal success.

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Faktor Determinan Hipertensi pada Pedagang Pasar Cibinong, Jawa Barat

Media Penelitian dan Pengembangan Kesehatan ◽

10.22435/mpk.v29i2.970 ◽

2019 ◽

Vol 29 (2) ◽

pp. 107-114

Author(s):

Mugi Wahidin ◽

Annisa Rizky Aprilia ◽

Dwi Susilo ◽

Sofa Farida

Keyword(s):

Logistic Regression ◽

Central Obesity ◽

Antihypertensive Drugs ◽

Public Health Problem ◽

Smoking History ◽

Bivariate Analysis ◽

Chi Square ◽

Cross Sectional ◽

Regular Treatment ◽

History Of

Abstract In Indonesia, the prevalence of hypertension has increased quite rapidly and has become a public health problem. Traditional market traders are prone to hypertension because of the high work pressure that often causes physical and mental fatigue. Athough research on hypertension risk factors has been carried out a lot, but research on market traders is still limited. This study was conducted with the aim to determine the proportion of hypertension in Cibinong market traders and the factors that influence it. The study was conducted with a cross sectional design using a quantitative analysis. Bivariate analysis was carried out by Chi Square test and multivariate analysis was performed with Multiple Logistic Regression tests. The study was conducted in November 2017 at Cibinong market, Bogor Regency, West Java. The sample size of 75 people with inclusion criteria had traded for at least 1 month and the exclusion criteria of traders had a history of hypertension and taking antihypertensive drugs. The dependent variable is hypertension while the independent variables are gender, age, type of trade, duration of trading, duration of work, sleep duration, family history of hypertension, smoking history, physical activity, fruit and vegetables consumption, obestity, and central obesity. The results showed that the proportion of hypertension was 30.7%. The factors indicated to be associated with hypertension were central obesity (OR 22.05; 95% CI 1.03-239.9) and gender (OR 9.1; 95% CI 1.06-78.3) after being tested together as other variables (multivariate). Suggestion are given to control hypertension in market traders especially for male traders with central obesity through regular checks and regular treatment. Abstrak Di Indonesia, prevalensi hipertensi meningkat cukup pesat dan menjadi masalah kesehatan masyarakat. Para pedagang pasar tradisional rentan mengalami hipertensi karena tingginya tekanan pekerjaan yang seringkali menyebabkan kelelahan fisik dan juga pikiran. Meskipun penelitian tentang faktor risiko hipertensi sudah banyak dilakukan, tetapi penelitian pada pedagang pasar masih terbatas. Penelitian ini dilakukan dengan tujuan untuk mengetahui proporsi hipertensi pada pedagang Pasar Cibinong dan faktor-faktor yang mempengaruhinya. Penelitian dilakukan dengan desain cross sectional (potong lintang) menggunakan pendekatan analisis secara kuantitatif. Analisis bivariat dilakukan dengan uji Chi Square dan analisis multivariat dilakukan dengan uji Logistic Regression ganda. Penelitian dilakukan pada November 2017 di Pasar Cibinong, Kabupaten Bogor, Jawa Barat. Besar sampel 75 orang dengan kriteria inklusi sudah berdagang minimal satu bulan dan kriteria eksklusi mempunyai riwayat hipertensi dan mengonsumsi obat anti hipertensi. Variabel dependen adalah hipertensi sedangkan variabel independen adalah jenis kelamin, umur, jenis dagangan, lama berdagang, durasi kerja, durasi tidur, riwayat keluarga hipertensi, riwayat merokok, aktivitas fisik, konsumsi buah dan sayur, obesitas dan obesitas sentral. Hasil penelitian menunjukkan bahwa kejadian hipertensi sebesar 30,7%. Faktor yang terindikasi berhubungan dengan hipertensi adalah obesitas sentral (OR 22,05; 95% CI 1,03-239,9) dan jenis kelamin (OR 9,1; 95% CI 1,06-78,3) setelah diuji bersama-sama dengan variabel lainnya (multivariat). Saran yang diberikan adalah pengendalian hipertensi pada pedagang pasar khususnya pedagang laki-laki dengan obesitas sentral melalui pemeriksaan berkala dan pengobatan secara teratur.

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Investigate the Effect of Diabetes on Hypertension based on Bangladesh Demography and Health Survey, 2017-18

10.21203/rs.3.rs-140346/v1 ◽

2021 ◽

Author(s):

Md. Merajul Islam ◽

Md. Jahanur Rahman ◽

Most. Tawabunnahar ◽

Md. Menhazul Abedin ◽

Md. Maniruzzaman

Keyword(s):

Logistic Regression ◽

Health Survey ◽

Age Groups ◽

Public Health Problem ◽

Binary Logistic Regression ◽

Bivariate Analysis ◽

P Value ◽

Diabetic Patients ◽

Major Public Health Problem ◽

Chi Square

Abstract Background and objectives: Hypertension is a major public health problem with raising its prevalence and effect among adults overtime worldwide, especially in Bangladesh. The aim is to investigate the effect of diabetes on hypertension.Materials and methods: The dataset used in this study was extracted from Bangladesh Demographic Health Survey, 2017-18 having a total of 6,965 (male: 3,376 and female: 3,589) adults whose ages were B35 years. Bivariate analysis along with Pearson’s chi-square test was executed to observe the association between different selected factors and hypertension. Additionally, binary logistic regression was employed to investigate the effect of diabetes on hypertension based on adjusted odds ratio (AOR) along with p-value in Bangladesh.Results: The results of the study revealed that average age of the participants was 51.04a12.731 and a total of 34.7 percent participants were identified as hypertension. Logistic regression analysis demonstrated that diabetic patients were 1.280 times (95% CI of AOR: 1.107-1.479; p-value=0.001) higher risk of hypertension compared to non-diabetic. Furthermore, our finding’s also showed that diabetic patient who was 35–49 years age, 1.462 times (95% CI of AOR: 1.182-1.807; p-value=0.000) higher risk of hypertension compared to age groups ≥50 years.Conclusions: Based on the results, this study claimed that people with diabetes was significantly associated with hypertension. This study suggested greater attention of government and policymakers to make appropriate strategies to reduce hypertension as well as associated risk in Bangladesh.

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Impact of Catheter Choice on Procedural Success of Minimally Invasive Surfactant Therapy

American Journal of Perinatology ◽

10.1055/s-0041-1733956 ◽

2021 ◽

Author(s):

Soume Bhattacharya ◽

Brooke Read ◽

Michael Miller ◽

Orlando da Silva

Keyword(s):

Adverse Effects ◽

Minimally Invasive ◽

Neonatal Intensive Care ◽

Tertiary Care ◽

Surfactant Therapy ◽

Positive Pressure ◽

P Value ◽

Chi Square ◽

Procedural Success ◽

The Impact

Objective Surfactant delivery via a thin endotracheal catheter during spontaneous breathing; a technique called minimally invasive surfactant therapy (MIST) is an alternative to intubation and surfactant administration. Procedural details among different centers vary, with marked differences in the choice of catheter to instill surfactant. Studies report use of feeding catheters, multiaccess suction catheters, vascular catheters, and more recently custom-built catheters for this purpose. The impact of choice of catheter on procedural success and procedural adverse effects has not been reported. Our present study compares the procedural success and adverse effects of MIST using a semirigid vascular catheter (16G Angiocath-Hobart Method) versus a flexible multiaccess catheter (MAC). Study Design This was a retrospective review of prospectively collected data at a tertiary care neonatal intensive care unit in Southwestern Ontario. All neonates who received surfactant via MIST between May 1, 2016 and September 30, 2020 were included in the study. Relevant baseline characteristics and data on procedural details (premedication, type of catheter, etc.) were collected. The procedural success, number of attempts, and adverse effects between neonates who received MIST via MAC and 16G Angiocath was compared by using Chi-square test or Fisher's test as appropriate. A p-value of less that 0.05 was considered significant. Results A total of 139 neonates received surfactant via MIST method during the study period. Moreover, 93 neonates received the surfactant via MAC, while 46 received it via Angiocath. The baseline demographic characteristics in the two group were similar. A higher proportion of neonates in Angiocath group received Atropine (100 vs. 76%, p = 0.002) and Fentanyl (98 vs. 36%, p < 0.001) than the MAC group.The procedural success was 91% in the Angiocath group and 89% in the MAC group (p > 0.99). Multiple attempts were needed in 24% of neonates in the Angiocath group and 37% in the MAC group (p = 0.158). More episodes of desaturations were noted in the Angiocath group (89%) than the MAC group (69%; p = 0.012). Other rates of common adverse effects were similar between the two groups. On exploratory analysis fentanyl use held significant association with less success, more desaturation, apneic episodes, and need of positive pressure ventilation /intubation. Conclusion The overall procedural success of MIST is similar in both catheter groups. The proportion of neonates requiring multiple attempts was lower with the Angiocath, though difference was not statistically significant. Desaturation episodes were seen more frequently in the Angiocath group, which was related to higher use of procedural sedation in this group. Key Points

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Impact of Delayed Admission to the Intensive Care Unit from the Emergency Department upon Sepsis Outcomes and Sepsis Protocol Compliance

Critical Care Research and Practice ◽

10.1155/2017/9616545 ◽

2017 ◽

Vol 2017 ◽

pp. 1-7 ◽

Cited By ~ 3

Author(s):

Michael Agustin ◽

Lori Lyn Price ◽

Augustine Andoh-Duku ◽

Peter LaCamera

Keyword(s):

Emergency Department ◽

Hospital Mortality ◽

Statistical Significance ◽

Tertiary Care ◽

Included Study ◽

Chi Square ◽

Significant Difference ◽

Protocol Compliance ◽

Sepsis And Septic Shock ◽

The Impact

Rationale. The impact of emergency department length of stay (EDLOS) upon sepsis outcomes needs clarification. We sought to better understand the relationship between EDLOS and both outcomes and protocol compliance in sepsis. Methods. We performed a retrospective observational study of septic patients admitted to the ICU from the ED between January 2012 and December 2015 in a single tertiary care teaching hospital. 287 patients with severe sepsis and septic shock were included. Study population was divided into patients with EDLOS < 6 hrs (early admission) versus ≥6 hours (delayed admission). We assessed the impact of EDLOS on hospital mortality, compliance with sepsis protocol, and resuscitation. Statistical significance was determined by chi-square test. Results. Of the 287 septic ED patients, 137 (47%) were admitted to the ICU in <6 hours. There was no significant in-hospital mortality difference between early and delayed admissions (p=0.68). Both groups have similar compliance with the 3-hour protocol (p=0.77). There was no significant difference in achieving optimal resuscitation within 12 hours (p=0.35). Conclusion. We found that clinical outcomes were not significantly different between early and delayed ICU admissions. Additionally, EDLOS did not impact compliance with the sepsis protocol with the exception of repeat lactate draw.

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