Introduction
Study aim
Methods
Study design and setting
Selection of participants
Methods and measurements
Fluid administration
Data analysis
Sample size
Descriptive statistics
Main analysis
Sensitivity analyses
Results
Patient characteristics
Total cohort N = 2659 | < 70 years N = 1678 | ≥ 70 years N = 981 | p value | |
---|---|---|---|---|
Patient demographics | ||||
Age, mean (SD) | 62.1 (17.1) | 52.5 (13.6) | 78.7 (6.3) | 0,000 |
Sex, n (%) | ||||
Female | 1143 (43.0) | 766 (45.6) | 377 (38.4) | 0.000 |
Male | 1516 (57.0) | 912 (54.4) | 604 (61.6) | |
Comorbidities, n (%) | ||||
COPD (2) | 416 (15.6) | 185 (11.0) | 231 (23.5) | 0.000 |
Heart disease (1) | 432 (16.1) | 156 (9.3) | 276 (28.1) | 0.000 |
Kidney disease (1) | 494 (18.5) | 282 (16.8) | 212 (21.6) | 0.002 |
Liver disease | 125 (4.7) | 102 (6.1) | 23 (2.3) | 0.000 |
Malignancy | 280 (10.5) | 173 (10.3) | 107 (10.9) | 0.628 |
Metastatic malignancy | 37 (13.9) | 256 (15.3) | 117 (11.9) | 0.017 |
Triage category (2), n (%) | 0.174 | |||
Blue | 2 (0.1) | 0 | 2 (0.2) | |
Green | 7 (0.3) | 5 (0.3) | 2 (0.2) | |
Yellow | 1233 (46.4) | 780 (46.5) | 453 (46.2) | |
Orange | 1365 (51.3) | 866 (51.6) | 499 (50.9) | |
Red | 50 (1.9) | 26 (1.5) | 24 (2.4) | |
Suspected site of infection, n (%) | ||||
Lungs | 1319 (49.3%) | 736 (43.9) | 583 (59.4) | 0.000 |
Urogenital tract | 797 (29.8) | 453 (27.0) | 344 (35.1) | 0.000 |
Abdomen | 459 (17.2) | 305 (18.2) | 154 (15.7) | 0.306 |
Skin | 245 (9.2) | 165 (9.8) | 80 (8.2) | 0.239 |
CNS | 68 (2.5) | 47 (2.8) | 21 (2.1) | 0.369 |
Other | 432 (16.1) | 323 (19.3) | 109 (11.1) | 0.000 |
Vital signs* | ||||
Respiratory rate, mean (SD) (590) | 24 (7) | 23 (7) | 26 (7) | 0.158 |
Heart rate, mean (SD) (46) | 108 (20) | 111 (19) | 103 (20) | 0.112 |
MAP, median (IQR) (247) | 94 (83–105) | 94 (84–105) | 94 (84–105) | 0.528 |
Systolic BP, median (IQR) (29) | 130 (115–149) | 129 (115–145) | 135 (115–154) | 0.000 |
Disease severity, median (IQR) | ||||
PIRO score | 10 (6–14) | 8 (4–12) | 13 (9–16) | 0.000 |
Lactate (mmol/L) (286) | 1.8 (1.4–0.6) | 1.80 (1.4–2.5) | 1.90 (1.4–2.7) | 0.023 |
Total amount of fluids received (L) (6) | 1.00 (0.5–1.5) | 1.00 (0.5–1.5) | 1.05 (0.5–1.5) | 0.128 |
Supplemental oxygen (L/min)** (78) | 2 (0–5) | 2 (0–4) | 3 (1–5) | 0.000 |
Mortality, n (%) | 172 (6.5) | 75 (4.5) | 97 (9.9) | 0.000 |
Main results
Intravenous fluids received in ED and ambulance (L) | ||||||
---|---|---|---|---|---|---|
< 70 years 0–1 | ≥ 70 years 0–1 | < 70 years 1–2 | ≥ 70 years 1–2 | < 70 years > 2 | ≥ 70 years > 2 | |
Patients (8), n | 1021 | 627 | 476 | 238 | 177 | 114 |
Absolute mortality (14), n (%) | 31 (3.0) | 56 (8.9) | 25 (5.3) | 18 (7.6) | 21 (11.9) | 23 (20.2) |
PIRO score, median (IQR) | 8 (4–12) | 13 (9–15) | 8 (4–12) | 13 (9–15) | 11 (7–14.5) | 14 (10–17) |
PI score, median (IQR) | 4 (2–5) | 6 (4–8) | 4 (2–5) | 6 (4–7) | 3 (2–5) | 5 (3–7) |
RO score (IQR) | 3 (2–8) | 7 (3–9) | 4 (2–8) | 8 (4–9) | 8 (4–10) | 8 (5–11.25) |
Supplemental oxygen (L/min) (23), median (IQR) | 0 (0–3) | 3 (1–5) | 2 (0–5) | 4 (2–7.5) | 5 (2–12.5) | 5 (3–15) |
Do Not Resuscitate status (3), n (%) | 127 (12.5) | 266 (42.4) | 53 (11.1) | 103 (43.3) | 29 (16.4) | 46 (40.4) |
IV fluids received at ED including in the ambulance (L) | OR (95% CI) | p value |
---|---|---|
SBP ≤ 120 mmHg | ||
0–1 L | 1.18 (0.47–2.97) | 0.726 |
1–2 L | 0.78 (0.26–2.15) | 0.644 |
> L | 1.08 (0.43–2.70) | 0.868 |
SBP > 120 mmHg | ||
0–1 L | 2.06 (1.02–4.16) | 0.045 |
1–2 L | 0.28 (0.07–1.04) | 0.057 |
> 2 L | 2.35 (0.59–9.45) | 0.228 |