Infections and severe sepsis in solid-organ transplant patients admitted from a university-based ED.
The objective was to provide a descriptive analysis of infectious processes in transplant patients admitted from the emergency department (ED). A database of all adult transplant patients at a university medical center was cross-referenced with a computerized record of all ED visits over an 18-month period. ED charts, inpatient records, and microbiology data were retrospectively reviewed. Final diagnoses and outcomes were analyzed. There were 352 ED visits by transplant patients (kidney 66%, kidney/pancreas 15%, liver 13%, lung 3%, heart 3%). Infections were the most common indications for admission (77/217, 35%). Urinary tract infection and pneumonia were the most common infections. Nine of 77 patients (11.7%) with documented infections developed severe sepsis, which was the most common reason for ICU utilization. Thirty-five percent of transplant patients admitted from the ED had acute infections, and 11.7% of these patients had severe sepsis. The emergency physician must have a high index of suspicion for infections when evaluating organ transplant recipients.
Trzeciak
Stephen
S
Department of Emergency Medicine, University of Illinois at Chicago, Chicago, IL, USA. TRZECIAK-STEPHEN@cooperhealth.edu
Sharer
Randall
R
Piper
Derek
D
Chan
Therese
T
Kessler
Chad
C
Dellinger
R Phillip
RP
Pursell
Kenneth J
KJ
D000328:Adult; D001424:Bacterial Infections / Q000453:epidemiology*; D003422:Critical Care / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D016027:Heart Transplantation / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016035:Pancreas Transplantation / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D018410:Pneumonia, Bacterial / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology*; D019737:Transplants / Q000706:statistics & numerical data*; D014552:Urinary Tract Infections / Q000453:epidemiology