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Westphal GA, Feijó J, Andrade PS, et al. Estratégia de detecção precoce e redução de mortalidade na sepse grave. Early detection strategy and mortality reduction in severe sepsis. Rev Bras Ter Intensiva. 2009;21(2):113-23
Westphal, G. A., Feijó, J., Andrade, P. S., Trindade, L., Suchard, C., Monteiro, M. A., Martins, S. F., Nunes, F., & Caldeira Filho, M. (2009). Estratégia de detecção precoce e redução de mortalidade na sepse grave. Early detection strategy and mortality reduction in severe sepsis. Revista Brasileira de terapia intensiva, 21(2), 113-23.
Westphal, Glauco Adrieno, et al. "Estratégia de detecção precoce e redução de mortalidade na sepse grave." Early detection strategy and mortality reduction in severe sepsis. Revista Brasileira de terapia intensiva vol. 21,2 (2009): 113-23.
Westphal GA, Feijó J, Andrade PS, Trindade L, Suchard C, Monteiro MA, Martins SF, Nunes F, Caldeira Filho M. Estratégia de detecção precoce e redução de mortalidade na sepse grave. Early detection strategy and mortality reduction in severe sepsis. Rev Bras Ter Intensiva. 2009 Jun;21(2):113-23. Portuguese. PMID: 25303339.
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Rev Bras Ter Intensiva. 2009 Jun;21(2):113-23.

Early detection strategy and mortality reduction in severe sepsis.

Revista Brasileira de terapia intensiva

[Article in Portuguese]
Glauco Adrieno Westphal, Janaína Feijó, Patrícia Silva de Andrade, Louise Trindade, Cezar Suchard, Márcio Andrei Gil Monteiro, Sheila Fonseca Martins, Fernanda Nunes, Milton Caldeira Filho

Affiliations

  1. Hospital Municipal São José, Joinville, SC, Brasil.
  2. Unidade de Terapia Intensiva Geral, Hospital Imperial de Caridade, Florianópolis, SC, Brasil.
  3. Universidade da Região de Joinville, Joinville, SC, Brasil.
  4. Centro de Controle de Infecção, Hospitalar do Hospital Municipal São José, Joinville, SC, Brasil.
  5. Unidade de Terapia Intensiva Geral, Hospitalar do Hospital Municipal São José.

PMID: 25303339

Abstract

OBJECTIVE: To evaluate the impact of implementing an institutional policy for detection of severe sepsis and septic shock.

METHODS: Study before (stage I), after (stage II) with prospective data collection in a 195 bed public hospital.. Stage I: Patients with severe sepsis or septic shock were included consecutively over 15 months and treated according to the Surviving Sepsis Campaign guidelines. Stage II: In the 10 subsequent months, patients with severe sepsis or septic shock were enrolled based on an active search for signs suggesting infection (SSI) in hospitalized patients. The two stages were compared for demographic variables, time needed for recognition of at least two signs suggesting infection (SSI-Δt), compliance to the bundles of 6 and 24 hours and mortality.

RESULTS: We identified 124 patients with severe sepsis or septic shock, 68 in stage I and 56 in stage II. The demographic variables were similar in both stages. The Δt-SSI was 34 ± 54 hours in stage I and 7 ± 8.4 hours in stage II (p <0.001). There was no difference in compliance to the bundles. In parallel there was significant reduction of mortality rates at 28 days (54.4% versus 30%, p <0.02) and hospital (67.6% versus 41%, p <0.003).

CONCLUSION: The strategy used helped to identify early risk of sepsis and resulted in decreased mortality associated with severe sepsis and septic shock.

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