title: Does sepsis treatment differ between primary and overflow intensive care units?
abstract: BACKGROUND
  Sepsis is a major cause of death in hospitalized patients. Early goal-directed therapy is the standard of care. When primary intensive care units (ICUs) are full, sepsis patients are cared for in overflow ICUs.
  
  
  OBJECTIVE
  To determine if process-of-care measures in the care of sepsis patients differed between primary and overflow ICUs at our institution.
  
  
  METHODS
  We conducted a retrospective study of all adult patients admitted with sepsis between July 2009 and February 2010 to either the primary ICU or the overflow ICU.
  
  
  METHODS
  Baseline patient characteristics and multiple process-of-care measures, including diagnostic and therapeutic interventions.
  
  
  RESULTS
  There were 141 patients admitted with sepsis to our hospital; 100 were cared for in the primary ICU and 41 in the overflow ICU. Baseline acute physiology and chronic health evaluation (APACHE II) scores were similar. Patients received similar processes-of-care in the primary ICU and overflow ICU with the exception of deep vein thrombosis (DVT) and gastrointestinal (GI) prophylaxis within 24 hours of admission, which were better adhered to in the primary ICU (74% vs 49%, P = 0.004, and 68% vs 44%, P = 0.012, respectively). There were no significant differences in hospital and ICU length of stay between the 2 units (9.68 days vs 9.73 days, P = 0.98, and 4.78 days vs 4.92 days, P = 0.97, respectively).
  
  
  CONCLUSIONS
  Patients with sepsis admitted to the primary ICU and overflow ICU at our institution were managed similarly. Overflowing sepsis patients to non-primary intensive care units may not affect guideline-concordant care delivery or length of stay.
authors.affiliation: Department of Medicine, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, Baltimore, Maryland 21224, USA. kvishnu1@jhmi.edu
authors.forename: Kittane
authors.initials: K
authors.lastname: Vishnupriya
authors.forename: Olufunmilayo
authors.initials: O
authors.lastname: Falade
authors.forename: Addisu
authors.initials: A
authors.lastname: Workneh
authors.forename: Satish
authors.initials: S
authors.lastname: Chandolu
authors.forename: Regina
authors.initials: R
authors.lastname: Landis
authors.forename: Kaweesa
authors.initials: K
authors.lastname: Elizabeth
authors.forename: Reethi
authors.initials: R
authors.lastname: Iyengar
authors.forename: Scott
authors.initials: S
authors.lastname: Wright
authors.forename: Jonathan
authors.initials: J
authors.lastname: Sevransky
mesh_terms: D018806:APACHE; D000368:Aged; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay; D008297:Male; D008396:Maryland; D005791:Patient Care / Q000379:methods*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018805:Sepsis / Q000188:drug therapy*; D013223:Statistics as Topic