Impact of a sepsis bundle in wards of a tertiary hospital
| Autor: | S. M. O. Bastos, C. F. T. Albuquerque, M. G. T. C. Alves, F. Teles, F. J. L. Silva, Eugen Mota, M. F. A. Mota, W. G. Rodrigues |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Sepsis bundle medicine.medical_treatment Psychological intervention Sepsis protocol Disease Wards Critical Care and Intensive Care Medicine Sepsis 03 medical and health sciences 0302 clinical medicine medicine 3-h bundle In patient 030212 general & internal medicine Mortality Intensive care medicine business.industry Research lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine lcsh:RC86-88.9 medicine.disease Icu admission Emergency medicine Managed care business Fluid replacement |
| Zdroj: | Journal of Intensive Care Journal of Intensive Care, Vol 5, Iss 1, Pp 1-5 (2017) |
| ISSN: | 2052-0492 |
| Popis: | Background Sepsis is a prevalent disease worldwide and still exhibits high rates of mortality. In the last years, many interventions aiming a positive impact on sepsis evolution have been studied. One of the main is the use of managed care protocols (sepsis bundles), which consist in systematization of diagnosis and treatment, such as standardization of antibiotics, collection of specific tests (cultures, lactate), and fluid replacement. Some studies have shown a reduction in hospital costs and lower mortality with the use of these tools. In the present study, we evaluated the impact of a sepsis bundle in wards of a tertiary hospital. Methods One hundred sixty-seven patients were retrospectively studied. The intervention was called “3-h bundle” and consisted of collecting lactate and cultures, start broad-spectrum antibiotics in the first hour of sepsis diagnosis, and volume replacement with crystalloid if hypotension or lactate ≥2 mmol/L. Results The overall mortality was 31.1%. Individuals who received the 3-h bundle showed a 44% lower mortality in comparison with who did not (25.6 vs. 45.7%; p = 0.01). Furthermore, the use of the sepsis bundle was independently correlated with lower mortality (OR = 0.175; CI = 0.04–0.64; p = 0.009). Therefore, a lower need for ICU admission and shorter length of stay in these units were observed in patients who received the intervention. Conclusion The use of a sepsis protocol with systematic care in wards was associated with lower mortality, less need for ICU admission and shorter stay on these units. Electronic supplementary material The online version of this article (doi:10.1186/s40560-017-0231-2) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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