Background: Following hospitalization, a reported 20% of all Medicare patients are discharged to skilled nursing facilities (SNFs).  Sepsis was the cause of 25-68% of readmissions from SNFs based on a review of Medicare readmissions from patients at 96 SNFs in southeast Michigan. Sepsis is also the most common all-cause admission diagnosis and represents over $20 [...]

Background: The randomized controlled ANZ-STATInS trial demonstrated that de novo statin use did not alter interleukin-6 levels or Sequential Organ Failure Assessment (SOFA) score in of what before SEPSIS-3 was known as severe sepsis. Prospective observational studies indicate that prior statin use sepsis is associated with a decreased rate of severe sepsis. We aimed to [...]

Background: In 2011, sepsis accounted for more than $20 billion (5.2%) of total US hospital costs.  The CDC estimates that hospitalizations for sepsis or septicemia increased from 621,000 to 1,141,000 in 2000 and 2008 respectively.  Severe sepsis has an in-hospital mortality rate of 28.6-37.7%, and those who survive may face a difficult recovery including long-term [...]

Background: Sepsis is a common, costly, and mortal clinical syndrome. Many delays in sepsis recognition and intervention are due to “data latency,” the period of time between data suggestive of sepsis being entered in the EHR to identification and interpretation by a care provider. The magnitude of this delay can be significant, as the diagnostic [...]

Background: Sepsis is a leading cause of death among hospitalized patients. Early detection of sepsis has the potential to reduce mortality by facilitating timely evidence-based interventions. Past studies have used electronic health records (EHR) to trigger alerts at the onset of sepsis, or to predict general clinical deterioration. In this study we describe the impact [...]

Background: Sepsis is a leading cause of mortality among hospitalized patients. Early detection and intervention reduces sepsis-related mortality. We implemented a novel early warning system (EWS 2.0) based on a machine-learning algorithm to prospectively identify patients with increased risk of severe sepsis or septic shock. Validation suggested excellent predictive characteristics, including a positive likelihood ratio [...]

Case Presentation: An 80 year-old man presented with one day of confusion, worsened cough, and subjective fevers. He had a productive cough since emigrating from Mexico six months ago, but no complaints of dyspnea. He had a history of diabetes and stable angina for the past year. On presentation, he was tachycardic with a temperature [...]

Case Presentation: A 26 year-old Singaporean man with no past medical history presented with two weeks of fevers and abdominal pain. Five months prior to admission, the patient traveled to Singapore.  Two weeks prior to presentation, he had an episode of sharp, right-sided abdominal pain accompanied by emesis.  He continued to have intermittent fevers, chills, [...]

Case Presentation: A 71 year old man with history of multiple sclerosis and gout (on Methylprednisolone) presented with weakness. Patient was diagnosed with a UTI on a recent hospital admission for fever and weakness. He improved on IV antibiotics and was discharged home to complete a 7-day PO course, but returned 9 days later after [...]

Case Presentation: 70 year old male admitted for a complicated UTI was placed on piperacillin / tazobactam empirically and subsequently developed abdominal distension and small bowel obstruction. He was admitted to the ICU for fulminant colitis secondary to severe Clostridium Difficile with concern for toxic megacolon. Labs showed a WBC of 34 along with an [...]