The Effect of the Intelligent Sepsis Management System on Outcomes among Patients with Sepsis and Septic Shock Diagnosed According to the Sepsis-3 Definition in the Emergency Department
- Authors
- Song, Juhyun; Cho, Hanjin; Park, Dae Won; Ahn, Sejoong; Kim, Joo Yeong; Seok, Hyeri; Park, Jonghak; Moon, Sungwoo
- Issue Date
- 11월-2019
- Publisher
- MDPI
- Keywords
- emergency department; mortality; sepsis; septic shock; Surviving Sepsis Campaign guidelines
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.8, no.11
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 8
- Number
- 11
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/61972
- DOI
- 10.3390/jcm8111800
- ISSN
- 2077-0383
- Abstract
- We developed a novel computer program, the Intelligent Sepsis Management System, based on Sepsis-3 definitions and 2016 Surviving Sepsis Campaign guidelines and performed a quasi-experimental pre-post study to assess its effect on compliance with the Surviving Sepsis Campaign guidelines and outcomes in patients with sepsis and septic shock. During the pre-period, patients were managed with usual care. During the post-period, patients were managed using the Intelligent Sepsis Management System upon arrival at the emergency department. A total of 631 patients were enrolled (pre-period, 316; post-period, 315). The overall compliance with the Surviving Sepsis Campaign guidelines' bundle improved (pre-period 10.8% vs. post-period 54.6%; p < 0.001). The post-period showed significantly lower 30-day mortality than the pre-period (pre-period 37.3% vs. post-period 29.5%; p = 0.037), but was not a protective factor for 30-day mortality, with an adjusted hazard ratio (95% confidence interval) of 0.75 (0.55-1.04) (p = 0.151). The associated factors for 30-day mortality were age, sequential organ failure assessment score, overall compliance, and lactate levels. The 30-day mortality was significantly lower in the compliance group than in the non-compliance group (27.2% vs. 36.5%; p = 0.002). After implementation of the Intelligent Sepsis Management System, overall compliance with the Surviving Sepsis Campaign guidelines improved and was associated with reduced 30-day mortality. However, we could not verify the causal effect of this system on 30-day mortality.
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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