Objectives:

To assess the interaction between ESRD-HD and sepsis

Aims:

1.      To ascertain the distribution of ESRD-HD patients presenting to the Emergency Department with  hypotension (SBP < 90 mmHg) with or without meeting SIRS criteria, and to compare their clinical outcomes.

2.      To ascertain the eventual ESRD-HD versus non-HD septic patients distribution, and their respective clinical outcomes, among patients presenting to the Emergency Department with  hypotension (SBP < 90 mmHg) with < 2 SIRS criteria (i.e., not meeting sepsis definition).

Design:

The AUBMC admissions, ED and ICD-9 clinical databases will be queried for the period between January 1, 2002 and June 30, 2012.

Retrospective database and chart review.

Study Endpoints:

Primary Outcome: Diagnosis of Sepsis

Secondary Outcomes: hospital death, length of stay, Multi-organ failure

The study population will consist of patients presenting and admitted to AUBMC through  AUBMC-ED over the past 10 years (2002-2012). 

They will have Sepsis, Bacteremia or Septic Shock as their final diagnosis. This population will be divided into 2 groups: Group A will include ESRD patients on HD and group B will include non HD patients. Each group will be subsequently divided into 2 groups: SBP < 90 mmHg and ≥ 90 mmHg. We will look at the presence of SIRS criteria in these groups. We speculate that the hypotensive ( SBP< or = 90 mmHg) category in Group A will exhibit less incidence of “presence of 2 SIRS criteria” compared to the hypotensive ( SBP< or = 90 mmHg) category in Group B. 

The AUBMC admissions, ED and ICD-9 clinical databases will be queried for the period between January 1, 2002 and June 30, 2012.