Impact of Sepsis Bundle Strategy on Outcomes of Patients Suffering from Severe Sepsis and Septic Shock in China

Wang, Zhen; Xiong, Yingxia; Schorr, Christa; Dellinger, R. Phillip

doi:10.1016/j.jemermed.2012.07.084

Cited by 47 publications

(40 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This is the largest prospective cohort of sepsis patients ever reported. Since the original report from the SSC [12], similar studies have been published from individual hospital networks [19][20][21] and national programs [22]. All published studies have demonstrated an association between improved compliance with guidelines-based sepsis bundles and survival.…”

Section: Discussionmentioning

confidence: 97%

Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study

et al. 2014

View full text Add to dashboard Cite

Purpose: To determine the association between compliance with the Surviving Sepsis Campaign (SSC) performance bundles and mortality. Design: Compliance with the SSC performance bundles, which are based on the 2004 SSC guidelines, was measured in 29,470 subjects entered into the SSC database from January 1, 2005 through June 30, 2012. Compliance was defined as evidence that all bundle elements were achieved. Setting: Two hundred eighteen community, academic, and tertiary care hospitals in the United States, South America, and Europe. Patients: Patients from the emergency department, medical and surgical wards, and ICU who met diagnosis criteria for severe sepsis and septic shock. Methods: A multifaceted, collaborative change intervention aimed at facilitating adoption of the SSC resuscitation and management bundles was introduced.

show abstract

Section: Discussionmentioning

confidence: 97%

Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study

et al. 2014

View full text Add to dashboard Cite

show abstract

“…Quality improvement projects that implemented sepsis resuscitation bundle [43] have been shown to reduce mortality in several settings [20, 22, 26]. However, the effect varied considerably and was often modest, particularly when instruction-based interventions were used [22].…”

Section: Discussionmentioning

confidence: 99%

“…Implementation barriers include delayed identification of septic patients, unawareness of or disagreement with guidelines, guideline complexity, lack of resources [17–19], staff shortage and unavailability of specialized setting required to put therapy into routine practice [9]. In the face of this complexity, different implementation strategies have been utilized, including education, posters, reminders, audit and feedback, paper-based and electronic sepsis screening tools, clinical pathways, rapid response teams and sepsis response teams (SRTs) [20–28]. The differential or the synergistic effect of these strategies on changing sepsis management practice has not been studied.…”

Section: Introductionmentioning

confidence: 99%

The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock

Arabi

Al‐Dorzi

Alamry

et al. 2017

Ann. Intensive Care

View full text Add to dashboard Cite

BackgroundCompliance with the clinical practice guidelines of sepsis management has been low. The objective of our study was to describe the results of implementing a multifaceted intervention including an electronic alert (e-alert) with a sepsis response team (SRT) on the outcome of patients with sepsis and septic shock presenting to the emergency department.MethodsThis was a pre–post two-phased implementation study that consisted of a pre-intervention phase (January 01, 2011–September 24, 2012), intervention phase I (multifaceted intervention including e-alert, from September 25, 2012–March 03, 2013) and intervention phase II when SRT was added (March 04, 2013–October 30, 2013) in a 900-bed tertiary-care academic hospital. We recorded baseline characteristics and processes of care in adult patients presenting with sepsis or septic shock. The primary outcome measures were hospital mortality. Secondary outcomes were the need for mechanical ventilation and length of stay in the intensive unit and in the hospital.ResultsAfter implementing the multifaceted intervention including e-alert and SRT, cases were identified with less severe clinical and laboratory abnormalities and the processes of care improved. When adjusted to propensity score, the interventions were associated with reduction in hospital mortality [for intervention phase II compared to pre-intervention: adjusted odds ratio (aOR) 0.71, 95% CI 0.58–0.85, p = 0.003], reduction in the need for mechanical ventilation (aOR 0.45, 95% CI 0.37–0.55, p < 0.0001) and reduction in ICU LOS and hospital LOS for all patients as well as ICU LOS for survivors.ConclusionsImplementing a multifaceted intervention including sepsis e-alert with SRT was associated with earlier identification of sepsis, increase in compliance with sepsis resuscitation bundle and reduction in the need for mechanical ventilation and reduction in hospital mortality and LOS.Electronic supplementary materialThe online version of this article (doi:10.1186/s13613-017-0280-7) contains supplementary material, which is available to authorized users.

show abstract

“…Esta situación fue descrita por Rivers en 2001 (28). La explicación posiblemente está en la falta de adherencia a las recomendaciones, problema reconocido en el manejo de la sepsis en el mundo (29)(30)(31)(32)(33), y a la dificultad diagnóstica debido al mimetismo de los signos y los síntomas de las infecciones con los cambios fisiológicos del embarazo (8)(9)(10)34).…”

Section: Discussionunclassified

Estudio de mortalidad materna por sepsis en Antioquia, Colombia, entre los años 2004-2014: una mirada al desafío de la identificación y el tratamiento oportunos

Velásquez-Penagos

Vélez-Álvarez

Gómez-Dávila

et al. 2017

Rev. Colomb. Obstet. Ginecol.

View full text Add to dashboard Cite

Objetivo: describir las características de las mujeres e identificar los factores de la atención que contribuyeron a las muertes maternas por sepsis en el departamento de Antioquia, Colombia.Materiales y métodos: serie de casos de las muertes maternas causadas por infección entre los años 2004 y 2014. Se analizaron las muertes maternas con base en las recomendaciones de la “Campaña para sobrevivir a la sepsis”, y en guías de práctica clínica de infecciones específicas. Los juicios se realizaron por consenso. Se evaluaron la oportunidad del diagnóstico de sepsis, el tratamiento antibiótico, el choque séptico, la toma de cultivos, la terminación del embarazo, la realización de la cirugía para control del foco infeccioso, el ingreso a unidad de cuidados intensivos, la remisión a un nivel de complejidad mayor y la calidad global del manejo. Análisis descriptivo.Resultados: de 476 muertes maternas, 47 (9,87 %) mujeres fallecieron por sepsis de origen no obstétrico y 11 (5,2 %) por infecciones propias del embarazo o puerperio. La neumonía fue la principal causa de muerte. Los principales factores que influyeron en el desenlace fueron las demoras en identificar el síndrome, en iniciar los antibióticos, asumir el manejo en niveles con baja capacidad resolutiva, tratamiento inadecuado del choque séptico y la falta de modificación de las conductas terapéuticas ante el deterioro de las pacientes.Conclusión: las muertes maternas por sepsis estuvieron principalmente asociadas a causas no obstétricas; hay factores críticos tales como el retraso en la identificación del síndrome, y el inicio oportuno y adecuado de los antibióticos que son susceptibles de intervención.

show abstract

Impact of Sepsis Bundle Strategy on Outcomes of Patients Suffering from Severe Sepsis and Septic Shock in China

Cited by 47 publications

References 12 publications

Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study

Surviving Sepsis Campaign: association between performance metrics and outcomes in a 7.5-year study

The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock

Estudio de mortalidad materna por sepsis en Antioquia, Colombia, entre los años 2004-2014: una mirada al desafío de la identificación y el tratamiento oportunos

Contact Info

Product

Resources

About