Cargando…
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
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...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912745/ https://www.ncbi.nlm.nih.gov/pubmed/31717855 http://dx.doi.org/10.3390/jcm8111800 |
_version_ | 1783479529512108032 |
---|---|
author | Song, Juhyun Cho, Hanjin Park, Dae Won Ahn, Sejoong Kim, Joo Yeong Seok, Hyeri Park, Jonghak Moon, Sungwoo |
author_facet | Song, Juhyun Cho, Hanjin Park, Dae Won Ahn, Sejoong Kim, Joo Yeong Seok, Hyeri Park, Jonghak Moon, Sungwoo |
author_sort | Song, Juhyun |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6912745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-69127452020-01-02 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 Song, Juhyun Cho, Hanjin Park, Dae Won Ahn, Sejoong Kim, Joo Yeong Seok, Hyeri Park, Jonghak Moon, Sungwoo J Clin Med Article 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. MDPI 2019-10-27 /pmc/articles/PMC6912745/ /pubmed/31717855 http://dx.doi.org/10.3390/jcm8111800 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Song, Juhyun Cho, Hanjin Park, Dae Won Ahn, Sejoong Kim, Joo Yeong Seok, Hyeri Park, Jonghak Moon, Sungwoo 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6912745/ https://www.ncbi.nlm.nih.gov/pubmed/31717855 http://dx.doi.org/10.3390/jcm8111800 |
work_keys_str_mv | AT songjuhyun theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT chohanjin theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT parkdaewon theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT ahnsejoong theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT kimjooyeong theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT seokhyeri theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT parkjonghak theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT moonsungwoo theeffectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT songjuhyun effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT chohanjin effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT parkdaewon effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT ahnsejoong effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT kimjooyeong effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT seokhyeri effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT parkjonghak effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment AT moonsungwoo effectoftheintelligentsepsismanagementsystemonoutcomesamongpatientswithsepsisandsepticshockdiagnosedaccordingtothesepsis3definitionintheemergencydepartment |