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Thesis/Dissertation Information
- Degree Disciplines:
- Nursing
Notes
- Abstract:
- Background: Sepsis is a lethal unpredictable critical illness characterized by maladaptive inflammatory immune responses that leads to multiple organ dysfunction syndrome. Purpose: to determine the effect of pre-existing health and acute illness characteristics on sepsis responses and outcomes in Intensive Care Unit patients. Theoretical Framework: Symptom Management Theory as the framework to visualize interrelationships between the abstract concepts of Predisposition, Insult/Injury, Response, and Outcomes (PIRO). Methods: Quantitative retrospective purposeful cohort causal-comparative design to determine the theoretic cause for differences among sepsis-comparison control groups. Results: Males had more severe sepsis (OR 1.17, p = 0.000, 95% CI [1.08; 1.28]), higher risk of mortality (OR 1.19, p = 0.002, 95% CI [1.06; 1.33]), and more acutely acquired organ dysfunction (AAOD) (OR 1.18, p = 0.000, 95% CI [1.08; 1.29]). Hispanics had more severe sepsis (OR 1.16, p = 0.000, 95% CI [1.07; 1.28]). Self-pay patients had higher hospital mortality (OR 1.63, p = 0.025, 95% CI [1.06; 2.50]) and higher ICU mortality (OR 2.18, p = 0.003, 95% CI [1.29; 3.69]). ICU admissions from the floor had more severe sepsis (OR 1.19, p = 0.000, 95% CI = [1.09; 1.31]); higher mortality (OR 1.48, p = 0.000, 95% CI [1.31; 1.68]), and more AAOD (OR 3.19, p = 0.000, 95% CI [2.89; 3.53]). After critical sepsis related and oncology acute illnesses, GI and renal acute diagnosis are the strongest theoretical causal predictors of sepsis severity (OR =1.65, p = 0.000, 95% CI = [1.39; 1.96]; OR = 1.44, p = 0.001, 95% CI = [1.16; 1.77]), mortality (OR = 1.51, p = 0.000, 95% CI = [1.18; 1.93]; OR = 1.64, p = 0.00, 95% CI = [1.45; 1.86]), and AAOD (OR = 1.69, p = 0.000, 95% CI = [1.41; 2.03]; OR = 1.25, p = 0.001, 95% CI = [1.09; 1.44]) respectfully. Conclusions: The theoretical causal predictors obtained through this exploratory analysis and mathematical prediction modeling yielded precise narrow point estimates suitable for confirmatory studies to further the development of the conceptual PIRO model. Armed with enhanced predictive knowledge, nurses may target the most vulnerable patients.
- Thesis:
- Thesis (Ph.D.)--Barry University, 2013.
- Bibliography:
- Includes bibliographical references (leaves 483-557).
Record Information
- Source Institution:
- Barry University
- Holding Location:
- Barry University Archives and Special Collections
- Rights Management:
- Copyright Donna Lee Armaignac. Permission granted to Barry University to digitize, archive and distribute this item for non-profit research and educational purposes. Any reuse of this item in excess of fair use or other copyright exemptions requires permission of the copyright holder.
- Resource Identifier:
- RC182.S4 A76 2013_ArmaignacDonna ( BU-Local )
- Classification:
- RC182.S4 A76 2013 ( lcc )
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