'Sepsis-related XXXX ' is absent at hospital presentation; a retrospective cohort analysis.

@entity1 @entity295 @entity308 @entity417 @entity326 @entity190 @entity1307 @entity177 @entity1011 @entity68
BACKGROUND: @entity417 is a common feature during @entity295 that occurs due to iatrogenic @entity190 , @entity308 of serum @entity68 levels and @entity1307 production, and a decreased lifespan of erythrocytes. However, these mechanisms are unlikely to play a role in @entity417 at the start of @entity295 . Moreover, sequestration of fluids, @entity177 and increase of intravascular space may additionally influence the change in hemoglobin concentration during intravenous fluid administration in the acute phase of @entity295 . METHODS: In this retrospective study, @entity1 who were admitted acutely to the Intensive Care Unit (ICU) were included. @entity1 who fulfilled the international criteria for severe @entity295 or @entity326 were included in the @entity295 group (S-group). The remaining @entity1 were allocated to the control group (C-group). Laboratory data from blood samples taken at first presentation to the hospital and at admission to the ICU, the amount of intravenous fluid administration and length of stay in the emergency department were collected and tested for significant differences between groups. RESULTS: The difference in hemoglobin concentration between the S-group (n   =   296) and C-group (n   =   320) at first presentation in hospital was not significant (8.8        1.2 versus 8.9        1.2  mmol/l, respectively, p   =   0.07). The reduction in hemoglobin concentration from the first presentation at the emergency department to ICU admission was significantly greater in the S-group compared to the C-group (1 [0.5-1.7] versus 0.5 [0.1-1.1] mmol/l, (p   <   0.001)). Spearman rho correlation coefficients between the reduction in hemoglobin concentration and the amount of intravenous fluids administered or the @entity1011 level in the emergency department were significant (0.3 and 0.4, respectively, p   <   0.001). In a multivariate regression analysis, @entity1011 , the amount of fluid administration and the presence of @entity295 remained independently associated. CONCLUSIONS: Prior to in-hospital intravenous fluid administration, there is no significant difference in hemoglobin concentration between acute septic @entity1 and acutely ill controls. Within several hours after hospital admission, there is a significant reduction in hemoglobin concentration, not only associated with the amount of intravenous fluids administered and the @entity1011 level, but also independently with @entity295 itself.
