Completion of the 1-Hour Sepsis Bundle on 90-Day Mortality in Adult Patients With Sepsis

完成1小时脓毒症治疗方案对成人脓毒症患者90天死亡率的影响

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Abstract

OBJECTIVES: Sepsis is a serious medical condition whose outcome might be improved by implementing the sepsis campaign's 1-hour bundle. To date, there is limited evidence that completion of the bundle improves 90-day mortality in adult patients with sepsis. This study aimed to evaluate whether completion of the 1-hour sepsis bundle was effective in reducing mortality at 90 days in adult patients with sepsis. METHODS: This was a retrospective cohort study that enrolled adult emergency department patients aged 18 years or older who met the criteria for sepsis or septic shock. Clinical factors were evaluated in eligible patients, who were then categorized into 2 groups: survivors and nonsurvivors. Factors predictive of mortality were calculated using logistic regression analysis. RESULTS: During the study period, 1617 patients met the study criteria. Of these, 605 patients (37.14%) died within 90 days. The predictive model for 90-day mortality included 6 factors. Of these, 5 factors were significantly associated with mortality: age, male sex, advanced liver disease, oxygen saturation, and completion of the 1-hour sepsis bundle. Completion of the 1-hour sepsis bundle demonstrated a decreased likelihood of death with an adjusted odds ratio of 0.75 (95% CI, 0.60-0.92). CONCLUSION: Completion of the 1-hour sepsis bundle may lower 90-day mortality in patients with sepsis. Additionally, age, male sex, advanced liver disease, and oxygen saturation were other clinical factors predictive of mortality in this setting. Further studies are required to confirm the results of this study, particularly in other hospital settings.

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