Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study.

Autor: Hyun, Dong-gon, Lee, Su Yeon, Ahn, Jee Hwan, Huh, Jin Won, Hong, Sang-Bum, Koh, Younsuck, Lim, Chae-Man, the Korean Sepsis Alliance (KSA) Investigators, Oh, Dong Kyu, Suh, Gee Young, Jeon, Kyeongman, Ko, Ryoung-Eun, Cho, Young-Jae, Lee, Yeon Joo, Lim, Sung Yoon, Park, Sunghoon, Heo, Jeongwon, Lee, Jae-myeong, Kim, Kyung Chan, Chang, Youjin
Zdroj: Critical Care; 9/16/2022, Vol. 26 Issue 1, p1-9, 9p
Abstrakt: Background: Hospital-onset sepsis is associated with a higher in-hospital mortality rate than community-onset sepsis. Many hospitals have implemented rapid response teams (RRTs) for early detection and timely management of at-risk hospitalized patients. However, the effectiveness of an all-day RRT over a non-all-day RRT in reducing the risk of in-hospital mortality in patient with hospital-onset sepsis is unclear. We aimed to determine the effect of the RRT's operating hours on in-hospital mortality in inpatient patients with sepsis.Methods: We conducted a nationwide cohort study of adult patients with hospital-onset sepsis prospectively collected from the Korean Sepsis Alliance (KSA) Database from 16 tertiary referral or university-affiliated hospitals in South Korea between September of 2019 and February of 2020. RRT was implemented in 11 hospitals, of which 5 (45.5%) operated 24-h RRT (all-day RRT) and the remaining 6 (54.5%) had part-day RRT (non-all-day RRT). The primary outcome was in-hospital mortality between the two groups.Results: Of the 405 patients with hospital-onset sepsis, 206 (50.9%) were admitted to hospitals operating all-day RRT, whereas 199 (49.1%) were hospitalized in hospitals with non-all-day RRT. A total of 73 of the 206 patients in the all-day group (35.4%) and 85 of the 199 patients in the non-all-day group (42.7%) died in the hospital (P = 0.133). After adjustments for co-variables, the implementation of all-day RRT was associated with a significant reduction in in-hospital mortality (adjusted odds ratio 0.57; 95% confidence interval 0.35-0.93; P = 0.024).Conclusions: In comparison with non-all-day RRTs, the availability of all-day RRTs was associated with reduced in-hospital mortality among patients with hospital-onset sepsis. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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