National Analysis of Sepsis Hospitalizations and Factors Contributing to Sepsis In-Hospital Mortality in Canada

Husak, Liudmila; Marcuzzi, Annette; Herring, Jeremy; Wen, Eugene; Yin, Ling; Capan, Dragos Daniel; Cernat, Geta

doi:10.12927/hcq.2010.21963

Cited by 49 publications

(68 citation statements)

References 10 publications

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“…[3][4][5] A 2009 report published by the Canadian Institute for Health Information provided an alarming picture of an escalating number of cases of sepsis on a national level. 6 In 2008-2009, they reported over 30,000 cases of sepsis hospitalizations in Canada, an increase by almost 4,000 from 2005. Mortality rates continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED), including myocardial infarction, trauma, and stroke.…”

Section: Introductionmentioning

confidence: 99%

Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative

McColl

Gatien

Calder

et al. 2016

CJEM

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Background: In 2008-2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol. The objective of this study was to evaluate the effects of this sepsis management bundle on patient mortality. Methods: This before and after study was conducted in two large Canadian tertiary care EDs and included adult patients with suspected severe infection that met at least two systemic inflammatory response syndrome (SIRS) criteria. We studied the implementation of a sepsis bundle including triage flagging, RN medical directive, education campaign, and a modified sepsis protocol. The primary outcomes were 30-day all-cause mortality and sepsis protocol use. Results: We included a total of 167 and 185 patients in the pre-and post-intervention analysis, respectively. Compared to the pre-intervention group, mortality was significantly lower in the post-intervention group (30.7% versus 17.3%; absolute difference, 13.4%; 95% CI 9.8-17.0; p = 0.006). There was also a higher rate of sepsis protocol use in the postintervention group (20.3% versus 80.5%, absolute difference 60.2%; 95% CI 55.1-65.3; p < 0.001). Additionally, we found shorter time-intervals from triage to MD assessment, fluid resuscitation, and antibiotic administration as well as lower rates of vasopressor requirements and ICU admission. Interpretation: The implementation of our multidisciplinary ED sepsis bundle, including improved early identification and protocolized medical care, was associated with improved time to achieve key therapeutic interventions and a reduction in 30-day mortality. Similar low-cost initiatives could be implemented in other EDs to potentially improve outcomes for this high-risk group of patients.

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Section: Introductionmentioning

confidence: 99%

Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative

McColl

Gatien

Calder

et al. 2016

CJEM

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“…In Canadian hospitals, sepsis is more common than cardiovascular disease, and has a higher fatality rate 1. In the United Kingdom, evidence from the National Health Service has recently shown that sepsis is responsible for more deaths annually than lung cancer, bowel cancer, and breast cancer 2.…”

Section: Introductionmentioning

confidence: 99%

Pediatric sepsis in the developing world: challenges in defining sepsis and issues in post-discharge mortality

Wiens¹,

Kumbakumba²,

Kissoon³

et al. 2012

CLEP

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Sepsis represents the progressive underlying inflammatory pathway secondary to any infectious illness, and ultimately is responsible for most infectious disease-related deaths. Addressing issues related to sepsis has been recognized as an important step towards reducing morbidity and mortality in developing countries, where the majority of the 7.5 million annual deaths in children under 5 years of age are considered to be secondary to sepsis. However, despite its prevalence, sepsis is largely neglected. Application of sepsis definitions created for use in resource-rich countries are neither practical nor feasible in most developing country settings, and alternative definitions designed for use in these settings need to be established. It has also been recognized that the inflammatory state created by sepsis increases the risk of post-discharge morbidity and mortality in developed countries, but exploration of this issue in developing countries is lacking. Research is urgently required to characterize better this potentially important issue.

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“…EE might reinforce the intestinal barrier by this mechanism and prevent the important phase of sepsis, translocation of intestinal flora. Mortality and morbidity from sepsis is common, usually after liver and lung dysfunction that are related to multiple organ failure [27]. Liver dysfunction is commonly seen in sepsis patients [28].…”

Section: Journal Of Investigative Surgerymentioning

confidence: 99%

Effects of Ecballium Elaterium on Proinflammatory Cytokines in a Rat Model of Sepsis

Arslan

Basuguy

İbiloğlu

et al. 2016

Journal of Investigative Surgery

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National Analysis of Sepsis Hospitalizations and Factors Contributing to Sepsis In-Hospital Mortality in Canada

Cited by 49 publications

References 10 publications

Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative

Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative

Pediatric sepsis in the developing world: challenges in defining sepsis and issues in post-discharge mortality

Effects of Ecballium Elaterium on Proinflammatory Cytokines in a Rat Model of Sepsis

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