Mortality from sepsis has decreased significantly within two years after the introduction of a state mandate requiring hospitals to follow a Protocol of action in sepsis and to report the results of treatment of patients, said the study published in the Journal of Respiratory and Critical Care Medicine.
The mandate prescribed hospitals to develop and submit for approval protocols for treatment of sepsis and to report regularly on the treatment and mortality of patients. Medical facilities could adapt the protocols, however, they necessarily had to include the main points:
- 3 hours (all patients with severe sepsis): the introduction of antibiotics and the measurement of lactate levels within three hours after a diagnosis of “sepsis”, with sampling of blood cultures before prescribing antibiotics;
- 6 hour (septic shock: systolic blood pressure < 90 mm Hg.St. or lactate > 4 mmol/l): intravenous bolus (300 cm3/kg), vasopressors for refractory hypotension, repeated changes of lactate levels within 6 hours after starting the Protocol.
To assess results from the initiative were analyzed 91 357 adult patients with sepsis and septic shock (mean age 71 years), hospitalized in 183 hospitals in the period April 2014 to June 2016
The results showed that 81.3% of patients were septic running protocols. The use of 3-hour Protocol has increased from 53.4% to 64.7%, 6 hours – from 23.9% to 30.8%.
Among patients against whom was applied the Protocol, the mortality-adjusted risk declined from 28.8% to implementation to 24.4% after, which means an absolute reduction in mortality of 4.4% relative to 15% over the study period.
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