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The Surviving Sepsis Campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study)

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Rhodes, Andrew Phillips, Gary Beale, Richard Cecconi, Maurizio Chiche, Jean Daniel Wittebole, Xavier [UCL] Levy, Mitchell

(eng) INTRODUCTION: Despite evidence demonstrating the value of performance initiatives, marked differences remain between hospitals in the delivery of care for patients with sepsis. The aims of this study were to improve our understanding of how compliance with the 3-h and 6-h Surviving Sepsis Campaign (SSC) bundles are used in different geographic areas, and how this relates to outcome. METHODS: This was a global, prospective, observational, quality improvement study of compliance with the SSC bundles in patients with either severe sepsis or septic shock. RESULTS: A total of 1794 patients from 62 countries were enrolled in the study with either severe sepsis or septic shock. Overall compliance with all the 3-h bundle metrics was 19%. This was associated with lower hospital mortality than non-compliance (20 vs. 31%, p < 0.001). Overall compliance with all the 6-h bundle metrics was 36%. This was associated with lower hospital mortality than non-compliance (22 vs. 32%, p < 0.001). After adjusting the crude mortality differences for ICU admission, sepsis status (severe sepsis or septic shock), location of diagnosis, APACHE II score and country, compliance remained independently associated with improvements in hospital mortality for both the 3-h bundle (OR = 0.64 (95% CI 0.47-0.87), p = 0.004)) and 6-h bundle (OR = 0.71 (95% CI 0.56-0.90), p = 0.005)). DISCUSSION: Compliance with all of the evidence-based bundle metrics was not high. Patients whose care included compliance with all of these metrics had a 40% reduction in the odds of dying in hospital with the 3-h bundle and 36% for the 6-h bundle.

Document type Article de périodique (Journal article) – Article de recherche
Access type Accès libre
Publication date 2015
Language Anglais
Journal information "Intensive Care Medicine" - Vol. 41, no. 9, p. 1620-1628 (2015)
Peer reviewed yes
Publisher Springer ((United States) New York, NY)
issn 0342-4642
e-issn 1432-1238
Publication status Publié
Affiliations UCL - SSS/IREC/MEDA - Pôle de médecine aiguë
UCL - (SLuc) Service de soins intensifs
Links
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Bibliographic reference Rhodes, Andrew ; Phillips, Gary ; Beale, Richard ; Cecconi, Maurizio ; Chiche, Jean Daniel ; et. al. The Surviving Sepsis Campaign bundles and outcome: results from the International Multicentre Prevalence Study on Sepsis (the IMPreSS study). In: Intensive Care Medicine, Vol. 41, no. 9, p. 1620-1628 (2015)
Permanent URL http://hdl.handle.net/2078.1/172185