The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock
Objective: To assess the impact of each measure in the six and 24-hour bundles of a Managed Care Program in the care of a cohort of hospitalized severe sepsis / septic shock patients. Methods: A prospective study was carried out with 316 consecutive patients with severe sepsis / septic shock, assess...
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| Format: | Article |
| Language: | English |
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2008-09-01
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| Series: | Einstein (São Paulo) |
| Subjects: | |
| Online Access: | http://apps.einstein.br/revista/arquivos/PDF/985-Einsteinv6n3p323-7.pdf |
| _version_ | 1818919263384109056 |
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| author | Alexandre Gonçalves de Sousa Constantino José Fernandes Junior Gisele de Paula Dias Santos Claudia Regina Laselva Joyce Polessi Luis Fernando Lisboa Nelson Akamine Eliézer Silva |
| author_facet | Alexandre Gonçalves de Sousa Constantino José Fernandes Junior Gisele de Paula Dias Santos Claudia Regina Laselva Joyce Polessi Luis Fernando Lisboa Nelson Akamine Eliézer Silva |
| author_sort | Alexandre Gonçalves de Sousa |
| collection | DOAJ |
| description | Objective: To assess the impact of each measure in the six and 24-hour bundles of a Managed Care Program in the care of a cohort of hospitalized severe sepsis / septic shock patients. Methods: A prospective study was carried out with 316 consecutive patients with severe sepsis / septic shock, assessing the impact on mortality by calculating the Odds Ratio of each single action (significance level of 5%). Rresults: In the sample there were 57% males, the mean age was 65.24 years, the APACHE II score was over 25 in 39.2%; 71.8% had a diagnosis of septic shock, and 65.5% required mechanical ventilation. Furthermore, 88.9% of patients had at least two organ dysfunctions upon the initial presentation. Only the blood culture collected before starting antibiotics: OR = 0.54 (95% CI: 0.33-0.87; p < 0.009) and the introduction of antibiotics by no later than 120 minutes after the diagnosis: OR = 0.44 (95% CI: 0.23-0.87; p < 0.009) were significant. Other six-hour bundle items tended towards a worse outcome. Results were superior in the 24-hour bundles with interventions in all four items, although without statistical significance. Cconclusions: The single impact of all interventions in the bundles occurred due to only two items: collecting blood cultures before starting antibiotics and early use (by 120 minutes) of antibiotics. Future evaluations in larger databases including multivariate analysis may support these findings. |
| first_indexed | 2024-12-20T01:03:05Z |
| format | Article |
| id | doaj.art-f7da4192b2f643b0b92b9837926c2ada |
| institution | Directory Open Access Journal |
| issn | 1679-4508 |
| language | English |
| last_indexed | 2024-12-20T01:03:05Z |
| publishDate | 2008-09-01 |
| publisher | Instituto Israelita de Ensino e Pesquisa Albert Einstein |
| record_format | Article |
| series | Einstein (São Paulo) |
| spelling | doaj.art-f7da4192b2f643b0b92b9837926c2ada2022-12-21T19:58:55ZengInstituto Israelita de Ensino e Pesquisa Albert EinsteinEinstein (São Paulo)1679-45082008-09-0163323327The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shockAlexandre Gonçalves de SousaConstantino José Fernandes JuniorGisele de Paula Dias SantosClaudia Regina LaselvaJoyce PolessiLuis Fernando LisboaNelson AkamineEliézer SilvaObjective: To assess the impact of each measure in the six and 24-hour bundles of a Managed Care Program in the care of a cohort of hospitalized severe sepsis / septic shock patients. Methods: A prospective study was carried out with 316 consecutive patients with severe sepsis / septic shock, assessing the impact on mortality by calculating the Odds Ratio of each single action (significance level of 5%). Rresults: In the sample there were 57% males, the mean age was 65.24 years, the APACHE II score was over 25 in 39.2%; 71.8% had a diagnosis of septic shock, and 65.5% required mechanical ventilation. Furthermore, 88.9% of patients had at least two organ dysfunctions upon the initial presentation. Only the blood culture collected before starting antibiotics: OR = 0.54 (95% CI: 0.33-0.87; p < 0.009) and the introduction of antibiotics by no later than 120 minutes after the diagnosis: OR = 0.44 (95% CI: 0.23-0.87; p < 0.009) were significant. Other six-hour bundle items tended towards a worse outcome. Results were superior in the 24-hour bundles with interventions in all four items, although without statistical significance. Cconclusions: The single impact of all interventions in the bundles occurred due to only two items: collecting blood cultures before starting antibiotics and early use (by 120 minutes) of antibiotics. Future evaluations in larger databases including multivariate analysis may support these findings.http://apps.einstein.br/revista/arquivos/PDF/985-Einsteinv6n3p323-7.pdfShockseptic/mortalitySepsis/mortalityHospital mortality |
| spellingShingle | Alexandre Gonçalves de Sousa Constantino José Fernandes Junior Gisele de Paula Dias Santos Claudia Regina Laselva Joyce Polessi Luis Fernando Lisboa Nelson Akamine Eliézer Silva The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock Einstein (São Paulo) Shock septic/mortality Sepsis/mortality Hospital mortality |
| title | The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock |
| title_full | The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock |
| title_fullStr | The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock |
| title_full_unstemmed | The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock |
| title_short | The impact of each action in the Surviving Sepsis Campaign measures on hospital mortality of patients with severe sepsis/septic shock |
| title_sort | impact of each action in the surviving sepsis campaign measures on hospital mortality of patients with severe sepsis septic shock |
| topic | Shock septic/mortality Sepsis/mortality Hospital mortality |
| url | http://apps.einstein.br/revista/arquivos/PDF/985-Einsteinv6n3p323-7.pdf |
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