The Knowledge of the Physicians about Sepsis Bundles is Suboptimal: A Multicenter Survey

Tufan, Zeliha Koçak; Eser, Fatma; Vudali, Emre; Batırel, Ayşe; Kayaaslan, Bircan; Baştuğ, Aliye; Eray, Deniz; Turhan, Vedat; Duygu, Fazılet; Tok, Duran; Altun, Şerife; Bulut, Cemal; Taşyaran, Mehmet A.

doi:10.7860/jcdr/2015/12954.6220

Cited by 11 publications

(13 citation statements)

References 14 publications

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“…We did not investigate compliance with sepsis bundles in Turkish ICUs in this study. However, in a previous multicenter study, it was found that physicians who were routinely in charge of sepsis patients in Turkey had poor knowledge of the sepsis bundles [ 39 ]. Delayed treatment and poor compliance with sepsis bundles are probably the most important causes of high mortality in patients with severe sepsis in Turkish ICUs.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study

et al. 2018

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BackgroundThe prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey.MethodsA total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included. The presence of systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock were assessed and documented based on the consensus criteria of the American College of Chest Physicians and Society of Critical Care Medicine (SEPSIS-I) in infected patients. Patients with septic shock were also assessed using the SEPSIS-III definitions. Data regarding demographics, illness severity, comorbidities, microbiology, therapies, length of stay, and outcomes (dead/alive during 30 days) were recorded.ResultsOf the 1499 patients included in the analysis, 237 (15.8%) had infection without SIRS, 163 (10.8%) had infection with SIRS, 260 (17.3%) had severe sepsis without shock, and 203 (13.5%) had septic shock. The mortality rates were higher in patients with severe sepsis (55.7%) and septic shock (70.4%) than those with infection alone (24.8%) and infection + SIRS (31.2%) (p < 0.001). According to SEPSIS-III, 104 (6.9%) patients had septic shock (mortality rate, 75.9%). The respiratory system (71.6%) was the most common site of infection, and Acinetobacter spp. (33.7%) were the most common isolated pathogen. Approximately, 74.9%, 39.1%, and 26.5% of Acinetobacter, Klebsiella, and Pseudomonas spp. isolates, respectively, were carbapenem-resistant, which was not associated with a higher mortality risk. Age, acute physiology and chronic health evaluation II score at ICU admission, sequential organ failure assessment score on study day, solid organ malignancy, presence of severe sepsis or shock, Candida spp. infection, renal replacement treatment, and a nurse-to-patient ratio of 1:4 (compared with a nurse-to-patient ratio of 1:2) were independent predictors of mortality in infected patients.ConclusionsA high prevalence of sepsis and an unacceptably high mortality rate were observed in Turkish ICUs. Although the prevalence of carbapenem resistance was high in Turkish ICUs, it was not associated with a higher risk for mortality.Trial registrationClinicalTrials.gov ID NCT03249246. Date: August 15, 2017. Retrospectively registered.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2013-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study

et al. 2018

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“…National and international support by politicians, researchers and clinicians is crucial [ 9 ]. To achieve this goal, it is necessary to expand education of sepsis for healthcare professionals, who also have large gaps in knowledge about sepsis diagnosis and management [ 24 , 25 ].…”

Section: Discussionmentioning

confidence: 99%

Determinants of sepsis knowledge: a representative survey of the elderly population in Germany

et al. 2018

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BackgroundSepsis is a life-threatening medical emergency requiring early diagnosis and urgent treatment. Knowledge is crucial, especially in major risk groups such as the elderly. We therefore assessed sophisticated knowledge about sepsis in the German elderly population.MethodsA telephone survey was carried out with a representative sample of 701 Germans from 16 federal states and a separate cohort of 700 participants from Thuringia, all aged ≥ 60 years. Sepsis knowledge was assessed via a 10-item questionnaire. Sociodemographic data and health information sources were assessed to identify determinants of sepsis knowledge.ResultsOf the participants, 88.6% had heard the term “sepsis” before; however, 50% of these failed to define sepsis correctly. Even if the knowledge of symptoms was moderately good, most participants could not correctly identify causes of sepsis and underestimated its incidence. Only a minority was aware that immunization may prevent sepsis. Regressions revealed that being younger, better educated and living in rural areas predicted higher levels of sepsis knowledge. Pharmacists were a relevant source of sepsis information.ConclusionsDespite overall awareness of sepsis, the understanding of its risk factors, symptoms and prevention is low in the elderly, with important implications for emergency and intensive care. We suggest further educational measures to improve early sepsis recognition and prevention through vaccination.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-2208-5) contains supplementary material, which is available to authorized users.

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“…Many studies revealed that clinical implementation of these bundle elements improve the quality of sepsis care and reduce hospital mortality. In 2012, the SSC 2008 guidelines were updated, and again in 2015; recommendations were classified as ones to be completed within three hours and others to be completed within six hours (Tufan et al, 2015). Of note, the 6-hour bundle was updated; the three-hour SSC bundle was not changed.…”

Section: Discussionmentioning

confidence: 99%

Severe Sepsis – Clinical Manifestations and Pharmaco-Economic Analysis in an Intensive Care Unit in Latvia

Brīdiņa

Krūmiņa

Šuba

et al. 2016

Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences.

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Sepsis is widespread among hospitalised patients worldwide. In fact, severe sepsis and septic shock is a major cause of patient admission and mortality in intensive care units and the difficulty in diagnosing the initial stage of the disease is a major obstacle to the reduction of mortality from sepsis. Retrospective analysis of medical records of 72 patients was carried out within the framework of the study. The study included patients of both sexes and all ages, who were hospitalised at the stationary “Gaiļezers” of the Rīga East Clinical University Hospital from 2011 to 2014. The study aim was to determine the clinical course of treated septic patients and conduct a pharmaco-economic analysis. In the course of the disease, almost half of the patients - 34 (48.6%) showed development of septic shock. Mortality in these patients exceeded a half (60.0%; 21 patients). Artificial lung ventilation during hospitalisation was received by 43 (59.7%) of patients. Artificial lung ventilation had been required in a significantly larger number of cases in the dead patient group (75%, p = 0.01). The average costs per one patient day (including bed-day price and manipulation costs) was 383 euros. Septic shock was associated with high mortality. Severe sepsis is an expensive diagnosis, as the average cost of one patient exceeds costs of other departments by 4.5 times.

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The Knowledge of the Physicians about Sepsis Bundles is Suboptimal: A Multicenter Survey

Cited by 11 publications

References 14 publications

Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study

Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study

Determinants of sepsis knowledge: a representative survey of the elderly population in Germany

Severe Sepsis – Clinical Manifestations and Pharmaco-Economic Analysis in an Intensive Care Unit in Latvia

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