Background Sepsis is a disease with an increasing prevalence and high hospital mortality rates. A hospital Multidisciplinary Working Group on Sepsis Code was created with the mission of implementing and developing clinical management guidelines to facilite soon detection, diagnosis and treatment of sepsis cases.
Purpose To describe the impact of the Sepsis Code on hospital length of stay, mortality in septic shock or severe sepsis patients and antibiotic use in this conditions.
Material and methods We carried out a retrospective observational study enrolling patients admitted to the UCI with severe sepsis or septic shock (SS).
The study included a post intervention group after Code Sepsis (POST-CS) (Agust 2012–August 2013) and a historical comparison group (PRE-CS) (January 2009–December 2009).
The following variables were recorded: sex, age, UCI mortality, hospital length of stay (days) in UCI, rate of the adequate antimicrobial therapy and de-escalation therapy. At admission to the ICU, severity of the illness was evaluated by the APACHE II score. Therapy was considered adequate when at least one effective drug was included in the empirical antibiotic treatment. De-escalation was defined as discontinuation of an antimicrobial agent or change to other with a narrower spectrum once culture results were available.
Results A total of 38 patients (60% male), mean age 64 years, with SS were enrolled in POST-CS group and 44 patients (63% male), mean age 58 yerars, with SS in PRE-CS group. The APACHE II score in PRE-CS was 21 vs 19 in POST-CS group.
Rate of de-escalation therapy was significantly higher in POST-CS group (39% vs 18%). In POST-CS group 63% patient received adequate empirical therapy and in PRE-CS group 59% patient. Patients in PRE-cs group had a significantly higher UCI mortality rate compared with patients in POST-CS group (39% vs 21%).
The POST-CS had also lower length of stay in UCI (9.8 vs16 days).
Conclusion The development of a training program, along with a set of actions aimed at the early detection of severe septic patients and optimising therapeutic measures included in a Code Sepsis decreases mortality and hospital length in UCI improving the management of antibiotic treatment.
References and/or Acknowledgements N/A
No conflict of interest.
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