| Assessing the effect of the surviving sepsis campaign treatment guidelines on clinical outcomes in a community hospital. | |
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MedLine Citation:
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PMID: 20978215 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Bundles yield a reduction in mortality in patients with sepsis, but the majority of the data is from large academic centers. The ability of a community hospital to implement a sepsis bundle successfully, however, has not been investigated. OBJECTIVE: To examine the effect of a collaborative 2-part sepsis bundle on clinical outcomes and mortality at a community hospital. METHODS: The study included all patients with severe sepsis/septic shock over the age of 18 years admitted to the intensive care unit (ICU) from 2006 to 2007 who were not treated with a bundle (n = 53) and those who were treated with a bundle (n = 59). Data collected included demographics; initiation of vasopressors; days on vasopressors; blood glucose; use of drotrecogin alfa (activated), steroids, and ventilator; ICU/hospital lengths of stay; ventilator days; time to culture; time to first dose of antibiotics; time to transfer from emergency department to ICU; fluid resuscitation in the first 24 hours; percentage of patients started on dialysis; and mortality. RESULTS: Demographics; blood glucose; use of drotrecogin alfa (activated), steroids and ventilator; ICU/hospital lengths of stay; and ventilator days were statistically similar between groups. Median time to cultures, first dose of antibiotics, and transfer to ICU were all reduced with the bundle. Percentage of non-bundle patients on vasopressors was 87% versus 66.7% of bundle patients (p = 0.011) and number of median days on vasopressors was reduced. Fewer bundle patients were initiated on dialysis (0%) versus non-bundle patients (14.8%) (p = 0.02). Median fluid administered in the first 24 hours was 2200 mL (10-13,996 mL) for non-bundle patients and 7143 mL (1000-19,104 mL) for bundle patients (p < 0.001). Mortality was 61.1% in the non-bundle group versus 20% with the bundle (p < 0.001). CONCLUSIONS: Implementation of a 2-part sepsis bundle based on the Surviving Sepsis Campaign Guidelines can yield a positive impact on clinical outcome and mortality in a nonacademic, community hospital setting. |
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Authors:
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Gita Wasan Patel; Nicki Roderman; Hollie Gehring; John Saad; William Bartek |
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Publication Detail:
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Type: Journal Article Date: 2010-10-26 |
Journal Detail:
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Title: The Annals of pharmacotherapy Volume: 44 ISSN: 1542-6270 ISO Abbreviation: Ann Pharmacother Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-04 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9203131 Medline TA: Ann Pharmacother Country: United States |
Other Details:
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Languages: eng Pagination: 1733-8 Citation Subset: IM |
Affiliation:
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Pharmacy Department, The Medical Center of Plano, TX, USA. Gita.patel@hcahealthcare.com |
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Comment In:
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Ann Pharmacother. 2010 Nov;44(11):1829-31
[PMID:
20978213
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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