Sepsis Code: dodging mortality in a tertiary hospital

Abstract

Background. In the hospital of La Princesa, the “Sepsis Code” (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it. Material and methods. A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05. Results. We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines. Conclusions. The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.

Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies

“…A published example of this CS model is that of the Hospital Universitario de La Princesa, known as the Princess Sepsis Code (PSC) [22]. A retrospective analysis of PSC patients was carried out between 2015 (the year of the hospital's PSC implementation) and 2018 to investigate whether the application of this model of care to patients with sepsis could improve outcomes.…”

Beneficios de la implementación del código sepsis en pacientes con shock séptico en el área hospitalaria

“…Méndez et al También menciona que los valores elevados de lactato, creatinina y la administración de aminas incrementan la mortalidad del paciente con sepsis o shock séptico y que la proteína C Reactiva es un factor importante a considerar para pronosticar una falla multiorgánica en el paciente. La investigación de más elementos que puedan beneficiar al paciente, y así disminuir mortalidad, será importante para incluir herramientas o factores en el código sepsis (8).…”

“…La implementación de un código sepsis en toda casa hospitalaria será prioridad para el personal de salud que recibe al paciente, el mismo que en muchas de las veces no puede dar una respuesta adecuada sobre su cuadro clínico, por lo tanto, es de suma importancia la preparación y experiencia del personal médico lo incrementará un diagnóstico especifico a tiempo y a su vez el tratamiento optimo, disminuyendo la morbilidad, complicaciones y muerte (8). https://doi.org/10.55204/trc.v3i1.e167…”

Usefulness of Procalcitonin Levels for Predicting the Microbiological Orientation in Patients with Sepsis

“…Without early detection and standardized care protocols for these patients, the mortality of this disease is very high. Sepsis performance improvement programs, which optimize organizational and educational processes to provide the best possible diagnosis and treatment in sepsis, have been shown to improve outcomes [1,2]. The Surviving Sepsis Campaign clinical guidelines [3] suggest the creation of such programs in different hospital centers.…”

“…Sex, patients admitted to Intensive Care Unit (ICU), and departments that activated the Sepsis Code alert 2. Age and clinical data.…”