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Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: A two-cohort study in 2005 and 2011.
Med Intensiva. 2017 Jan - Feb; 41(1):28-37.MI

Abstract

OBJECTIVE

To analyze the evolution of sepsis-related mortality in Spanish Intensive Care Units (ICUs) following introduction of the Surviving Sepsis Campaign (SSC) guidelines and the relationship with sepsis process-of-care.

DESIGN

A prospective cohort study was carried out, with the inclusion of all consecutive patients presenting severe sepsis or septic shock admitted to 41 Spanish ICUs during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group).

SCOPE

Patients with severe sepsis or septic shock admitted to Spanish ICUs.

PATIENTS

All ICU admissions from the emergency department or wards and all ICU patients with a diagnosis of severe sepsis or septic shock. A total of 1348 patients were included: 630 in the 2005 group and 718 in the 2011 group.

INTERVENTION

None.

PRIMARY ENDPOINTS

ICU mortality, 28-day mortality and Hospital mortality, hospital length of stay, ICU length of stay and compliance with the resuscitation bundle.

RESULTS

Compliance with the resuscitation bundle was significantly greater in the 2011 group (5.7% vs. 9.9%; p=0.005), and was associated to lower mortality (OR 0.602 [0.365-0.994]; p=0.048). The 2011 group had lower absolute in-hospital mortality (44.0% vs. 32.6%; p=0.01), 28-day mortality (36.5% vs. 23.0%; p=0.01), and adjusted mortality (OR 0.64 [0.49-0.83], p=0.001).

CONCLUSIONS

Mortality related to severe sepsis or septic shock in Spain decreased between two patient cohorts in 2005 and 2011, and was attributable to earliness and improvement in sepsis care.

Authors+Show Affiliations

Intensive Care Department, Hospital Universitari Mútua Terrassa, PhD Programme, University of Barcelona, Barcelona, Spain.Intensive Care Department, Vall d'Hebron University Hospital, Autonomous University of Barcelona, Barcelona, Spain; CIBER Enfermedades Respiratorias, Spain; Shock, organ dysfunction and Resuscitation Research Group (SODIR), VHIR, Barcelona, Spain. Electronic address: r.ferrer@vhebron.net.Epidemiology and Assessment Unit, Fundació Parc Tauli, Autonomous University of Barcelona, Sabadell, Spain.Intensive Care Department, Hospital Universitari Mútua Terrassa, PhD Programme, University of Barcelona, Barcelona, Spain.Intensive Care Department, Hospital Universitari Mútua Terrassa, PhD Programme, University of Barcelona, Barcelona, Spain.CIBER Enfermedades Respiratorias, Spain; Critical Care Centre, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Autonomous University of Barcelona, Sabadell, Spain.CIBER Enfermedades Respiratorias, Spain; Critical Care Centre, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Autonomous University of Barcelona, Sabadell, Spain.CIBER Enfermedades Respiratorias, Spain; Critical Care Centre, Hospital de Sabadell, Corporació Sanitària Universitària Parc Taulí, Autonomous University of Barcelona, Sabadell, Spain.No affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Observational Study

Language

eng spa

PubMed ID

28029501

Citation

Sánchez, B, et al. "Declining Mortality Due to Severe Sepsis and Septic Shock in Spanish Intensive Care Units: a Two-cohort Study in 2005 and 2011." Medicina Intensiva, vol. 41, no. 1, 2017, pp. 28-37.
Sánchez B, Ferrer R, Suarez D, et al. Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: A two-cohort study in 2005 and 2011. Med Intensiva. 2017;41(1):28-37.
Sánchez, B., Ferrer, R., Suarez, D., Romay, E., Piacentini, E., Gomà, G., Martínez, M. L., & Artigas, A. (2017). Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: A two-cohort study in 2005 and 2011. Medicina Intensiva, 41(1), 28-37. https://doi.org/10.1016/j.medin.2016.09.004
Sánchez B, et al. Declining Mortality Due to Severe Sepsis and Septic Shock in Spanish Intensive Care Units: a Two-cohort Study in 2005 and 2011. Med Intensiva. 2017 Jan - Feb;41(1):28-37. PubMed PMID: 28029501.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Declining mortality due to severe sepsis and septic shock in Spanish intensive care units: A two-cohort study in 2005 and 2011. AU - Sánchez,B, AU - Ferrer,R, AU - Suarez,D, AU - Romay,E, AU - Piacentini,E, AU - Gomà,G, AU - Martínez,M L, AU - Artigas,A, AU - ,, Y1 - 2016/10/28/ PY - 2016/05/12/received PY - 2016/09/04/revised PY - 2016/09/07/accepted PY - 2016/12/29/pubmed PY - 2018/3/29/medline PY - 2016/12/29/entrez KW - Critical care KW - Guidelines KW - Guías KW - Medicina intensiva KW - Mortalidad KW - Mortality KW - Sepsis SP - 28 EP - 37 JF - Medicina intensiva JO - Med Intensiva VL - 41 IS - 1 N2 - OBJECTIVE: To analyze the evolution of sepsis-related mortality in Spanish Intensive Care Units (ICUs) following introduction of the Surviving Sepsis Campaign (SSC) guidelines and the relationship with sepsis process-of-care. DESIGN: A prospective cohort study was carried out, with the inclusion of all consecutive patients presenting severe sepsis or septic shock admitted to 41 Spanish ICUs during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group). SCOPE: Patients with severe sepsis or septic shock admitted to Spanish ICUs. PATIENTS: All ICU admissions from the emergency department or wards and all ICU patients with a diagnosis of severe sepsis or septic shock. A total of 1348 patients were included: 630 in the 2005 group and 718 in the 2011 group. INTERVENTION: None. PRIMARY ENDPOINTS: ICU mortality, 28-day mortality and Hospital mortality, hospital length of stay, ICU length of stay and compliance with the resuscitation bundle. RESULTS: Compliance with the resuscitation bundle was significantly greater in the 2011 group (5.7% vs. 9.9%; p=0.005), and was associated to lower mortality (OR 0.602 [0.365-0.994]; p=0.048). The 2011 group had lower absolute in-hospital mortality (44.0% vs. 32.6%; p=0.01), 28-day mortality (36.5% vs. 23.0%; p=0.01), and adjusted mortality (OR 0.64 [0.49-0.83], p=0.001). CONCLUSIONS: Mortality related to severe sepsis or septic shock in Spain decreased between two patient cohorts in 2005 and 2011, and was attributable to earliness and improvement in sepsis care. SN - 1578-6749 UR - https://www.unboundmedicine.com/medline/citation/28029501/Declining_mortality_due_to_severe_sepsis_and_septic_shock_in_Spanish_intensive_care_units:_A_two_cohort_study_in_2005_and_2011_ L2 - http://www.elsevier.es/en/linksolver/ft/pii/S0210-5691(16)30189-9 DB - PRIME DP - Unbound Medicine ER -