Compliance with the 2016 Surviving Sepsis Campaign Bundle and the 2018 Surviving Sepsis Campaign 1-Hour Bundle and patient outcomes in emergency presentation at a tertiary referral hospital

Compliance in Sepsis Management

Abstract

Background & Objective: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis has always been associated with high morbidity and mortality. Consensus committees of international organizations have recommended packages to reduce the high mortality. We evaluated the 2016 Surviving Sepsis Campaign (SSC) package with 3 and 6-hour sepsis packages and the 2018 SSC with 1-hour sepsis package on the mortality of septic patients who came to a tertiary referral hospital.

Methodology: We enrolled 164 retrospective cohort patients in the tertiary emergency referral general hospital resuscitation ward. The patients were followed up for 48 h of observation. Sepsis and septic shock criteria are based on the Third International Consensus Definition of Sepsis and Septic Shock (Sepsis-3) 2016. Patients were divided into 3 groups, based upon compliance with SSC 16 at 3 h, 6 h, and SSC 18 at 1 h, and the mortality was recorded before 48 h and after 48 h.

Results: Compliance rates at 1 h (27.4%), 3 h (39.6%), and 6 h (43.3%) were significantly associated with patient mortality (P ≤ 0.001). Population patients who met the criteria for SSC, 73.3% had been referred from peripheral  hospitals. The mortality rate was 76 (46.34%) for < 48 h and 37 (22.56%) for more than 48 h.

Conclusion: Compliance with sepsis management contributes to improved patient condition and a better prognosis when the Surviving Sepsis Campaign package is adequately implemented.

Abbreviations: SSC - Surviving Sepsis Campaign; SOFA - Sequential Organ Failure Assessment; qSOFA - quick Sequential Organ Failure Assessment; VIS - Vasopressor Inotropic Score

Key words: Sepsis; SSC Sepsis Bundle Compliance-2016; 1 Hour SSC Sepsis Package 2018; Death; Vasopressors; Outcome; Mortality

Citation: Utariani A, Semedi BP, Salinding A, Hamzah H. Compliance with the 2016 Surviving Sepsis Campaign Bundle and the 2018 Surviving Sepsis Campaign 1-Hour Bundle and patient outcomes in emergency presentation at a tertiary referral hospital. Anaesth. pain intensive care 2023;27(5):478−485; DOI: 10.35975/apic.v27i5.1852

Received: March 26, 2022; Reviewed: December 21, 2022; Accepted: August 08, 2023