Evidence map›Paper›PMID 32176076›Full record

ArticleMedicine2020

History of diabetes may delay antibiotic administration in patients with severe sepsis presenting to emergency departments.

Toshikazu Abe, Tomoharu Suzuki, Shigeki Kushimoto, Seitaro Fujishima, Takehiro Sugiyama, Masao Iwagami, Hiroshi Ogura, Atsushi Shiraishi, Daizoh Saitoh, Toshihiko Mayumi and 24 more

Open access · goldAbstract read
In one paragraph

Article in Medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.1field-weighted citation impact, top 51% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

34 authors at 14 institutions in 3 countries.

Toshikazu AbeDepartment of General Medicine, Juntendo University, Tokyo.
Tomoharu SuzukiDepartment of General Medicine, Urasoe General Hospital, Urasoe.
Shigeki KushimotoDivision of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Sendai.
Seitaro FujishimaCenter for General Medicine Education, Keio University School of Medicine.
Takehiro SugiyamaHealth Services Research and Development Center, University of Tsukuba, Tsukuba.
Masao IwagamiHealth Services Research and Development Center, University of Tsukuba, Tsukuba.
Hiroshi OguraDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka.
Atsushi ShiraishiEmergency and Trauma Center, Kameda Medical Center, Kamogawa.
Daizoh SaitohDivision of Traumatology, Research Institute, National Defense Medical College, Tokorozawa.
Toshihiko MayumiDepartment of Emergency Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu.
Hiroki IriyamaDepartment of General Medicine, Juntendo University, Tokyo.
Akira KomoriDepartment of General Medicine, Juntendo University, Tokyo.
Taka-Aki NakadaDepartment of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba.
Yasukazu ShiinoDepartment of Acute Medicine, Kawasaki Medical School, Kurashiki, Japan.
Takehiko TaruiDepartment of Trauma and Critical Care Medicine, Kyorin University School of Medicine.
Toru HifumiDepartment of Emergency and Critical Care Medicine, St. Luke's International Hospital.
Yasuhiro OtomoTrauma and Acute Critical Care Center, Medical Hospital, Tokyo Medical and Dental University, Tokyo, Japan.
Kohji OkamotoDepartment of Surgery, Center for Gastroenterology and Liver Disease, Kitakyushu City Yahata Hospital, Kitakyushu.
Yutaka UmemuraDepartment of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, Osaka.
Joji KotaniDivision of Disaster and Emergency Medicine, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe.
Yuichiro SakamotoEmergency and Critical Care Medicine, Saga University Hospital, Saga.
Junichi SasakiDepartment of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo.
Shin-Ichiro ShiraishiDepartment of Emergency and Critical Care Medicine, Aizu Chuo Hospital, Aizuwakamatsu.
Ryosuke TsurutaAdvanced Medical Emergency & Critical Care Center, Yamaguchi University Hospital, Ube.
Akiyoshi HagiwaraDepartment of Emergency Medicine, Niizashiki Chuo General Hospital.
Kazuma YamakawaDivision of Trauma and Surgical Critical Care, Osaka General Medical Center, Osaka.
Kiyotsugu TakumaEmergency & Critical Care Center, Kawasaki Municipal Kawasaki Hospital, Kawasaki.
Tomohiko MasunoDepartment of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo.
Naoshi TakeyamaAdvanced Critical Care Center, Aichi Medical University Hospital, Nagakute.
Norio YamashitaAdvanced Emergency Medical Service Center, Kurume University Hospital, Kurume.
Hiroto IkedaDepartment of Emergency Medicine, Teikyo University School of Medicine, Tokyo.
Masashi UeyamaDepartment of Trauma, Critical Care Medicine, and Burn Center Community Healthcare Organization, Chukyo Hospital, Nagoya.
Satoshi GandoDivision of Acute and Critical Care Medicine, Hokkaido University Graduate School of Medicine.
for JAAM FORECAST group
Suzuki (Japan) · JPUniversity of Tsukuba · JPChiba University · JPChukyo Hospital · JPGunma Chuo Hospital · JPKameda Medical Center · JPKeio University · JPKin-ikyo Chuo Hospital · JPKitakyushu City Yahata Hospital · JPNational Defense Medical College · JPNippon Medical School · JPOsaka University · JPSt. Luke's International Hospital · JPUniversity of Occupational and Environmental Health Japan · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Clinical manifestations of sepsis differ between patients with and without diabetes mellitus (DM), and these differences could influence the clinical behaviors of medical staff. Therefore, we aimed to investigate whether pre-existing DM was associated with the time to antibiotics or sepsis care protocols.This was a retrospective cohort study.It conducted at 53 intensive care units (ICUs) in Japan.Consecutive adult patients with severe sepsis admitted directly to ICUs form emergency departments from January 2016 to March 2017 were included.The primary outcome was time to antibiotics.Of the 619 eligible patients, 142 had DM and 477 did not have DM. The median times (interquartile ranges) to antibiotics in patients with and without DM were 103 minutes (60-180 minutes) and 86 minutes (45-155 minutes), respectively (P = .05). There were no significant differences in the rates of compliance with sepsis protocols or with patient-centred outcomes such as in-hospital mortality. The mortality rates of patients with and without DM were 23.9% and 21.6%, respectively (P = .55). Comparing patients with and without DM, the gamma generalized linear model-adjusted relative difference indicated that patients with DM had a delay to starting antibiotics of 26.5% (95% confidence intervals (95%CI): 4.6-52.8, P = .02). The gamma generalized linear model-adjusted relative difference with multiple imputation for missing data of sequential organ failure assessment was 19.9% (95%CI: 1.0-42.3, P = .04). The linear regression model-adjusted beta coefficient indicated that patients with DM had a delay to starting antibiotics of 29.2 minutes (95%CI: 6.8-51.7, P = .01). Logistic regression modelling showed that pre-existing DM was not associated with in-hospital mortality (odds ratio, 1.26; 95%CI: 0.72-2.19, P = .42).Pre-existing DM was associated with delayed antibiotic administration among patients with severe sepsis or septic shock; however, patient-centred outcomes and compliance with sepsis care protocols were comparable.

Indexed as

Emergency Service, HospitalTime-to-TreatmentAgedAged, 80 and overAnti-Bacterial AgentsDiabetes MellitusFemaleHospital MortalityHumansJapanMaleRetrospective StudiesSepsisAnti-Bacterial Agents

Identifiers

PMID32176076
PMCPMC7220469
OpenAlexW3011331114

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.