he aim of this study was to compare the outcomes of patients with septic shock (SS) over
a 12-month Period in a closed MICU setting, presenting during diff
erent times of the day.
Patients admitted to the medical intensive care unit (MICU) between January 2009 to
January 2010 of a tertiary care center, who fulfi
lled the already reported consensus criteria for
septic shock were included in this study.
A total of 100 patients admitted to MICU with the diagnosis of SS were included in
this study. Patients were divided into four groups on the basis of their presentation time (Group
1: 6AM-11:59 AM, Group 2: 12:00 PM- 5:59 PM, Group 3: 6PM-11:59PM & Group 4: 12:00
AM- 5:59 AM).
e mean age of cohort was 66.75 yr with 60% males. No signifi
erences were noted
among the four groups with the respect to age, gender, hypertension, CAD, DM and COPD (P
e clinical out comes in the four groups were compared in terms of need for ventilator
& inotropic support, number of deaths and length of stay of the patients in the MICU among
e patients in group A i.e. between 6 AM-11: 59 AM were found to have worse out come
as compared to the patients in group B, C and D.
e main fi
nding of this retrospective study is that patients admitted to MICU
in the morning hours have worse prognosis, as compared to the patients admitted during the
rest of the days. A change in the organizational/staffi
ng structure of a closed MICU during the
early morning likely explains the increased mortality noted. It is likely that a number of factors
in combination, including the morning rounds account for the higher risk of death during the
Our study showed that the patients with septic shock follow the same circadian rhythm
in respect to their all-clinical out comes. Th
e patients presented in fi
rst quadrant i.e. between
6AM-11: 59 AM had worse out come as compared to the other patients presenting in the other
e data suggests that septic shock patients presenting early in the day have worse
prognosis as compared to the patients presenting late during the day.
Dr. Aziz is currently working as Internal Medicine resident at Jersey City Medical Center/ Mount Sinai School
of Medicine. In addition to being an outstanding researcher, Dr. Aziz has authored several articles on different
topics of his research and is working right now on many important research projects related to Critical Care
medicine and Cardiology. These articles have also been cited hundreds of times by other researchers in the
fi eld. Dr. Aziz has presented his fi ndings at various medical conferences and published in several internationally
read peer-reviewed journals. In addition to that he is a member of editorial board of several well-recognized
journal. His work has been well recognized both nationally and internationally.
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