B Sánchez1, R Ferrer2, D Suarez3, E Romay1, E Piacentini1, G Gomà4, M L Martínez4, A Artigas4. 1. Intensive Care Department, Hospital Universitari Mútua Terrassa, PhD Programme, University of Barcelona, Barcelona, Spain. 2. Intensive Care Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER Enfermedades Respiratorias, Spain; Shock, organ dysfunction and Resuscitation Research Group (SODIR), VHIR, Barcelona, Spain. Electronic address: r.ferrer@vhebron.net. 3. Epidemiology and Assessment Unit, Fundació Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain. 4. CIBER Enfermedades Respiratorias, Spain; Critical Care Centre, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Autonomous University of Barcelona, Sabadell, Spain.
Abstract
OBJECTIVE: To analyze the evolution of sepsis-related mortality in Spanish Intensive Care Units (ICUs) following introduction of the Surviving Sepsis Campaign (SSC) guidelines and the relationship with sepsis process-of-care. DESIGN: A prospective cohort study was carried out, with the inclusion of all consecutive patients presenting severe sepsis or septic shock admitted to 41 Spanish ICUs during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group). SCOPE: Patients with severe sepsis or septic shock admitted to Spanish ICUs. PATIENTS: All ICU admissions from the emergency department or wards and all ICU patients with a diagnosis of severe sepsis or septic shock. A total of 1348 patients were included: 630 in the 2005 group and 718 in the 2011 group. INTERVENTION: None. PRIMARY ENDPOINTS: ICU mortality, 28-day mortality and Hospital mortality, hospital length of stay, ICU length of stay and compliance with the resuscitation bundle. RESULTS: Compliance with the resuscitation bundle was significantly greater in the 2011 group (5.7% vs. 9.9%; p=0.005), and was associated to lower mortality (OR 0.602 [0.365-0.994]; p=0.048). The 2011 group had lower absolute in-hospital mortality (44.0% vs. 32.6%; p=0.01), 28-day mortality (36.5% vs. 23.0%; p=0.01), and adjusted mortality (OR 0.64 [0.49-0.83], p=0.001). CONCLUSIONS: Mortality related to severe sepsis or septic shock in Spain decreased between two patient cohorts in 2005 and 2011, and was attributable to earliness and improvement in sepsis care.
OBJECTIVE: To analyze the evolution of sepsis-related mortality in Spanish Intensive Care Units (ICUs) following introduction of the Surviving Sepsis Campaign (SSC) guidelines and the relationship with sepsis process-of-care. DESIGN: A prospective cohort study was carried out, with the inclusion of all consecutive patients presenting severe sepsis or septic shock admitted to 41 Spanish ICUs during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group). SCOPE: Patients with severe sepsis or septic shock admitted to Spanish ICUs. PATIENTS: All ICU admissions from the emergency department or wards and all ICU patients with a diagnosis of severe sepsis or septic shock. A total of 1348 patients were included: 630 in the 2005 group and 718 in the 2011 group. INTERVENTION: None. PRIMARY ENDPOINTS: ICU mortality, 28-day mortality and Hospital mortality, hospital length of stay, ICU length of stay and compliance with the resuscitation bundle. RESULTS: Compliance with the resuscitation bundle was significantly greater in the 2011 group (5.7% vs. 9.9%; p=0.005), and was associated to lower mortality (OR 0.602 [0.365-0.994]; p=0.048). The 2011 group had lower absolute in-hospital mortality (44.0% vs. 32.6%; p=0.01), 28-day mortality (36.5% vs. 23.0%; p=0.01), and adjusted mortality (OR 0.64 [0.49-0.83], p=0.001). CONCLUSIONS: Mortality related to severe sepsis or septic shock in Spain decreased between two patient cohorts in 2005 and 2011, and was attributable to earliness and improvement in sepsis care.
Authors: Ignacio Martin-Loeches; Arturo Muriel-Bombín; Ricard Ferrer; Antonio Artigas; Jordi Sole-Violan; Leonardo Lorente; David Andaluz-Ojeda; Adriele Prina-Mello; Ruben Herrán-Monge; Borja Suberviola; Ana Rodriguez-Fernandez; Pedro Merino; Ana M Loza; Pablo Garcia-Olivares; Eduardo Anton; Eduardo Tamayo; Wysali Trapiello; Jesús Blanco; Jesús F Bermejo-Martin Journal: Ann Intensive Care Date: 2017-04-20 Impact factor: 6.925
Authors: Ricard Ferrer; María Luisa Martínez; Gemma Gomà; David Suárez; Luis Álvarez-Rocha; María Victoria de la Torre; Gumersindo González; Rafael Zaragoza; Marcio Borges; Jesús Blanco; Eduardo Palencia Herrejón; Antonio Artigas Journal: Crit Care Date: 2018-06-22 Impact factor: 9.097