Reduced mortality after the implementation of a protocol for the early detection of severe sepsis

J Crit Care. 2011 Feb;26(1):76-81. doi: 10.1016/j.jcrc.2010.08.001. Epub 2010 Oct 30.

Abstract

Objective: We evaluate the impact that implementing an in-hospital protocol for the early detection of sepsis risk has on mortality from severe sepsis/septic shock.

Methods: This 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.

Results: We 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).

Conclusion: The early detection of sepsis promoted early treatment, reducing in-hospital mortality from severe sepsis/septic shock.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Brazil / epidemiology
  • Clinical Protocols*
  • Early Diagnosis
  • Female
  • Guideline Adherence
  • Hospital Mortality*
  • Hospitals, General
  • Humans
  • Intensive Care Units / standards
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Practice Guidelines as Topic
  • Prospective Studies
  • Risk Assessment
  • Sepsis / diagnosis*
  • Sepsis / mortality*
  • Time Factors