Reduced mortality after the implementation of a protocol for the early detection of severe sepsis |
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Authors: | Westphal Glauco A Koenig Álvaro Caldeira Filho Milton Feijó Janaína de Oliveira Louise Trindade Nunes Fernanda Fujiwara Kênia Martins Sheila Fonseca Roman Gonçalves Anderson R |
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Affiliation: | a Hospital Municipal São José, Joinville, Brazil 89202-000b Centro Hospitalar Unimed, Joinville, Brazil 89204-060 |
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Abstract: | ObjectiveWe evaluate the impact that implementing an in-hospital protocol for the early detection of sepsis risk has on mortality from severe sepsis/septic shock.MethodsThis was a prospective cohort study conducted in 2 phases at 2 general hospitals in Brazil. In phase I, patients with severe sepsis/septic shock were identified and treated in accordance with the Surviving Sepsis Campaign guidelines. Over the subsequent 12 months (phase II), patients with severe sepsis/septic shock were identified by means of active surveillance for signs of sepsis risk (SSR). We compared the 2 cohorts in terms of demographic variables, the time required for the identification of at least 2 SSRs, compliance with sepsis bundles (6- and 24-hour), and mortality rates.ResultsWe identified 217 patients with severe sepsis/septic shock (102 during phase I and 115 during phase II). There were significant differences between phases I and II in terms of the time required for the identification of at least 2 SSRs (34 ± 48 vs 11 ± 17 hours; P < .001) and in terms of in-hospital mortality (61.7% vs 38.2%; P < .001).ConclusionThe early detection of sepsis promoted early treatment, reducing in-hospital mortality from severe sepsis/septic shock. |
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Keywords: | Septic shock Severe sepsis Outcomes Diagnosis, Hospital mortality |
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