Sepsis Bundle Compliance and Mortality according to Body Temperature of Patients with Sepsis in General Wards Identified Using the Rapid Response System

Abstract

Purpose : This study aimed to investigate the difference in compliance with the sepsis bundle and mortality rates according to the body temperature of patients with sepsis in general wards identified using a rapid response system (RRS). Methods : A retrospective observational study of 1,083 patients with sepsis in general wards identified using the RRS from July 2018 to December 2022 was performed at a tertiary care hospital in South Korea. The patients were classified into hypothermia (＜36℃), normothermia (36-38℃), and hyperthermia (＞38℃) groups according to their body temperature at the time of RRS activation. Results : A total of 1,083 sepsis patients were analyzed, comprising 17 cases of hypothermia, 624 cases of normothermia, and 442 cases of hyperthermia. There were statistically significant differences among the body temperature groups in the rate of compliance with the sepsis bundle within 1 h (hypothermia: 64.7% vs. normothermia: 49.5% vs. hyperthermia: 60.4%, <i>p</i> =.010), the rate of compliance with the overall sepsis bundle, including lactate re-measurement (64.7% vs. 49.5% vs. 60.4%, <i>p</i> =.001), and the rate of blood culture testing (94.1% vs. 85.9% vs. 92.8%, <i>p</i> =.002). The 28-day mortality rates in the hypothermia, normothermia, and hyperthermia groups were 29.4%, 32.4%, and 16.5%, respectively (<i>p</i> ＜.001). Conclusion : There were statistically significant differences in compliance with the sepsis bundle and mortality rates according to body temperature. Patients with sepsis and normothermia showed lower compliance with the sepsis bundle and higher mortality rates. Therefore, it is recommended to develop strategies for the early recognition of patients with sepsis and normothermia and to improve compliance with the sepsis bundle.