Montefiore in the News
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Montefiore in the News

November 1, 2019

Madaline T, et al. Open Forum Infect Dis. 2019;doi:10.1093/ofid/ofz408.


Theresa Madaline

Receiving an infectious disease consultation within 12 hours of arriving at the hospital was associated with a 40% reduced risk for in-hospital mortality among patients with sepsis, according to recently published study findings.

“Sepsis is a serious illness that carries substantial risk of morbidity and mortality. However, judicious antimicrobial use is also important to prevent drug resistance and adverse events,” Theresa Madaline, MD, assistant professor of Medicine at Albert Einstein College of Medicine and health care epidemiologist at Montefiore Health System, told Infectious Disease News. “We know infectious diseases consultation results in better patient outcomes in many conditions and also improves sepsis bundle compliance, but we wanted to find out if infectious diseases consultation had an effect on sepsis-related outcomes beyond just improving compliance with the sepsis bundle.”

Madaline and colleagues assessed 248 adult ED patients with severe sepsis and septic shock who completed a 3-hour treatment bundle and compared patients who received an ID consultation within 12 hours of ED triage and those who received standard care.

According to Madaline, they found that people who presented to the ED with severe sepsis or septic shock and were seen by an ID physician within 12 hours of arrival had significantly lower mortality rates than people who were not seen by a specialist or who were seen later in their hospitalization. Specifically, in-hospital mortality was 24.3% in the early ID consult group vs. 38% in the standard care group.

“We were proud to report that patients seen within 12 hours by one of our infectious diseases specialists also had a shorter time to de-escalation of antibiotics,” Madaline said.

The researchers noted that there was no significant difference in 30-day readmission (22.6% vs. 23.5%) or median length of stay (10.2 vs. 12.1 days) between the groups. 

“Our study adds to a rapidly growing body of literature demonstrating improved outcomes and shorter time to de-escalation of antibiotics for people with sepsis or other infectious conditions when an infectious diseases specialist is part of the care team, particularly when this occurs early in the course of illness,” Madaline said.

“Infectious diseases physicians are incredibly valuable members of the care team, and are experts at antibiotic management. When possible, the involvement of infectious diseases physicians in every sepsis case should be considered. This said, it is also important to remember that diagnosing and treating severe sepsis can be a big challenge, and it is important to remember there is ‘no one size fits all’ model for treating people impacted by this condition.” – by Caitlyn Stulpin

Disclosure: Madaline reports no relevant financial disclosures.