TY - JOUR
T1 - Managing sepsis
T2 - Electronic recognition, rapid response teams, and standardized care save lives
AU - Guirgis, Faheem W.
AU - Jones, Lisa
AU - Esma, Rhemar
AU - Weiss, Alice
AU - McCurdy, Kaitlin
AU - Ferreira, Jason
AU - Cannon, Christina
AU - McLauchlin, Laura
AU - Smotherman, Carmen
AU - Kraemer, Dale F.
AU - Gerdik, Cynthia
AU - Webb, Kendall
AU - Ra, Jin
AU - Moore, Frederick A.
AU - Gray-Eurom, Kelly
N1 - Publisher Copyright:
© 2017 Elsevier Inc.
PY - 2017/8
Y1 - 2017/8
N2 - Purpose Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. Materials and methods Retrospective review of patients ≥ 18 years treated for sepsis. Results There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p = 0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p = 0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39–0.99, p = 0.046), mean intensive care unit LOS (2.12 days before, 95%CI 1.97, 2.34; 1.95 days after, 95%CI 1.75, 2.06; p < 0.001), mean overall hospital LOS (11.7 days before, 95% CI 10.9, 12.7 days; 9.9 days after, 95% CI 9.3, 10.6 days, p < 0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p = 0.007), and total charges with a savings of $7159 per sepsis admission (p = 0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p = 0.18). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.
AB - Purpose Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. Materials and methods Retrospective review of patients ≥ 18 years treated for sepsis. Results There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p = 0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p = 0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39–0.99, p = 0.046), mean intensive care unit LOS (2.12 days before, 95%CI 1.97, 2.34; 1.95 days after, 95%CI 1.75, 2.06; p < 0.001), mean overall hospital LOS (11.7 days before, 95% CI 10.9, 12.7 days; 9.9 days after, 95% CI 9.3, 10.6 days, p < 0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p = 0.007), and total charges with a savings of $7159 per sepsis admission (p = 0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p = 0.18). Conclusion A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis.
KW - Clinical decision support
KW - Rapid response teams
KW - Resuscitation
KW - Sepsis
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U2 - 10.1016/j.jcrc.2017.04.005
DO - 10.1016/j.jcrc.2017.04.005
M3 - Article
C2 - 28412015
AN - SCOPUS:85017476406
SN - 0883-9441
VL - 40
SP - 296
EP - 302
JO - Journal of Critical Care
JF - Journal of Critical Care
ER -