Early treatment strategies in sepsis

doi:10.1136/bmj.39507.433333.80

BMJ 2008;336:521 (8 March), doi:10.1136/bmj.39507.433333.80

Letters

Bloodstream infection

Early treatment strategies in sepsis

The first 150 words of the full text of this article appear below.

Minton et al add to a gathering body of evidence that poor clinicalpractice in the initial management of patients with bloodstreaminfections contributes to increased morbidity and mortality.¹

We recently performed a retrospective study of 35 patients withcommunity acquired pneumonia and septicaemia transferred within48 hours of admission to a district general intensive care unitover a year. Outcomes were death or discharge from hospital.

Mean age was 59 (range 14-96), 19 were male, and 24 were smokers.Patients over 65 had a 53% mortality compared with 22% in thoseunder 65. Smokers had a 46% mortality compared with 18% in non-smokers.

CURB 65 scores (Confusion, elevated Urea, elevated Respiratoryrate, low Blood pressure and age at least 65) were grouped 0/1,2/3, and 4/5. Mortality was 30% in the 0/1 and 2/3 groups. Patientsscoring 4/5 on admission, however, had 80% mortality.

. . . [Full text of this article]

Mohammed A Butt, ST2 general medicine, A K Coulson, F2 medicine, J H Hull, specialist registrar respiratory medicine, T B L Ho, consultant respiratory physician

¹ Knight Centre for Cystic Fibrosis, Department of Respiratory Medicine, Frimley Park Hospital, Camberley GU16 7UJ

adilbutt@doctors.org.uk

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