Sepsis in Critically Ill Patients at a Community Acute Care Hospital: MATERIALS AND METHODS
The health records of all patients in the ICU who received DAA from May 2003, when it was first used at this institution, until April 2007 were retrospectively evaluated. Patients who had received DAA were identified by searching the database of medication orders of the hospital’s information system. The health records of patients who had received DAA were reviewed by a pharmacist (Z.K.), and relevant data were collected using a predefined data collection tool. The primary objective was to evaluate the appropriateness of DAA utilization according to the institution’s criteria. Appropriateness was evaluated for all patients who had received DAA, but there was no attempt to identify patients who could have received DAA but did not. The secondary objectives were to characterize, for this institution, the patients and types of infections for which DAA was used and to evaluate mortality in the ICU, 28-day mortality, serious bleeding events during the infusion, and wastage of this agent. Serious bleeding was defined, in accordance with the PROWESS study, as any intracranial hemorrhage, life- threatening bleeding, bleeding event classified as serious by the investigator, or bleeding that required the administration of 3 units of packed red cells on 2 consecutive days. Bleeding events were captured by screening the physician’s notes and transfusion records. Wastage was determined by counting the number of completely or partially unused bags of DAA that were returned to the pharmacy and the number of bags of DAA that were prepared by the pharmacy but not dispensed.
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