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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...

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Autores principales: Song, Juhyun, Cho, Hanjin, Park, Dae Won, Ahn, Sejoong, Kim, Joo Yeong, Seok, Hyeri, Park, Jonghak, Moon, Sungwoo
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
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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.
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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
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