Abstract
Methods During an two years period, severe sepsis and septic shock patients detected in a teaching hospital were prospectively evaluated, Clinical and microbiological variables and process indicators such as delay of lactate extraction, inadequate empirical antibiotic treatment (IEAT) rates and antibiotic administration were recorded. Mortality rates, % of admissions at ICU and length of stay were also collected. Two different periods were analysed in order to analyse the possible differences in process indicators, mortality rates and length of stay. Period A: From 1-October2102 to 15-June-2013 when a manual electronic check list to guide the detection of these patients was applied and Period B: From 16-June-2013 to 30-September 2014 when AEAP was implemented. A univariate analysis was performed to define the possible differences between to periods using SPSS package (15.0). Statistical significance was considered when p value < 0.05.
Highlights
To describe the clinical and epidemiological characteristics of patients with severe sepsis and septic shock detected by a sepsis unit in ED of a tertiary hospital and to analyse the influence of the IMPLEMENTATION OF AUTOMATIC ELECTRONIC ALERT PROGRAM (AEAP) on process indicators, length of stay and outcome of patients with severe sepsis and septic shock detected by a sepsis unit
The number of activations was higher in period B (254 vs. 785 episodes) the rate of admissions in ICU diminished in a significant way. (30.7 % vs. 27.4%; p = 0.03) Statistically significant differences were observed for the rate of appropriate empirical antibiotic therapy (40% vs. 13%. p = 0.01) between two periods
There were no significant differences in global mortality rate (23.2% vs. 23.3%) and length of stay (11.8 ± 13,6 vs 10.60 ± 13,7 days) between two groups when patients with LTS were excluded the diminution of mortality rates became significant (14.6% vs. 13.7%; p = 0,02)
Summary
To describe the clinical and epidemiological characteristics of patients with severe sepsis and septic shock detected by a sepsis unit in ED of a tertiary hospital and to analyse the influence of the IMPLEMENTATION OF AUTOMATIC ELECTRONIC ALERT PROGRAM (AEAP) on process indicators, length of stay and outcome of patients with severe sepsis and septic shock detected by a sepsis unit
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