• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Emergency

Sepsis performance measure implementation not associated with clinical outcomes improvement

byThomas SuandHarsh Shah
May 3, 2021
in Emergency, Infectious Disease, Public Health
Reading Time: 2 mins read
0
Share on FacebookShare on Twitter

1. Adoption of the Severe Sepsis and Septic Shock Early Management Bundle (SEP-1) program resulted in greater adherence to individual process measures such as lactate measurement, early antibiotics, and fluid therapy.

2. These increases were variable in magnitude and did not associate with meaningful changes in sepsis outcomes.

Evidence Rating Level: 2 (Good)

Study Rundown: Sepsis is associated with significant mortality and consistently ranks among the costliest inpatient conditions in the United States. Evidence-based protocols for early sepsis therapy have been shown to reduce preventable morbidity and mortality, but there has been pushback against mandatory adherence due to clinician concerns regarding unintended harms, including antimicrobial resistance and unnecessary diversion of health care resources. As such, this study evaluated the longitudinal changes in sepsis treatment and outcomes that arose from SEP-1 implementation. SEP-1 implementation was associated with substantial increases in three-hour lactate measurement and six-hour repeat lactate measurement as well as minor increases in antibiotic administration and intravenous fluid administration. However, statistically significant between-group differences were not observed in any of the three clinical outcomes of intensive care unit admission, in-hospital mortality, or home discharge. This study was limited by the lack of a control group and thus relied on the assumption that sepsis trends were unchanged over the study period. Overall, these results suggested that SEP-1 had variable effects on target clinical outcome measures for sepsis.

Click here to read the study in Annals of Internal Medicine

Relevant Reading: Evidence underpinning the Centers for Medicare & Medicaid Services’ Severe Sepsis and Septic Shock Management Bundle (SEP-1): a systematic review.

In-Depth [retrospective cohort]: This longitudinal study utilized electronic health record data from 11 hospitals in the University of Pittsburgh Medical Center (UPMC) Health System from January 2013 to December 2017. The study encompassed 54,255 unique patient encounters. Patients who met the criteria of suspected infection and organ dysfunction within six hours of arrival to the emergency department (ED) were included in the study. Patients excluded from the study were those transferred to the ED and repeated encounters. SEP-1 implementation led to dramatic increases in adherence to three-hour lactate measurement (absolute difference, 23.7 percentage points; 95% confidence interval [CI], 20.7 to 26.7 percentage points; P < 0.001) and six-hour repeat lactate measurement (absolute difference, 17.4 percentage points; 95% CI, 14.4 to 20.4 percentage points; P < 0.001). Clinical outcomes were generally similar in the pre-SEP-1 and post-SEP-1 periods; ICU admissions were numerically greater (absolute difference, 2.0 percentage points; 95% CI, 0 to 4.0 percentage points; P = 0.055), as was mortality (absolute change, 0.1 percentage points; 95% CI, -0.9 to 1.1 percentage points; P = 0.87). Consequently, fewer patients were discharged home (absolute difference, -1.8 percentage points; 95% CI, -4.1 to 0.6 percentage points; P = 0.145). Overall, SEP-1 implementation was not shown to result in a meaningful association with changes in sepsis outcomes.

RELATED REPORTS

Balanced intravenous solutions reduce risk of hyperchloremia in the pediatric intensive care unit

#VisualAbstract: Restriction of Intravenous Fluids in ICU Patients with Septic Shock

#VisualAbstract: Intravenous vitamin C increases mortality and organ dysfunction in sepsis patients

Image: PD

©2021 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: ICU admissionmortality outcomessepsisSevere Sepsis and Septic Shock Early Management Bundle (SEP-1)
Previous Post

Bariatric surgery vs community weight management for idiopathic intracranial hypertension

Next Post

Bimekizumab superior to secukinumab for plaque psoriasis treatment

RelatedReports

Hypotonic IVF linked to increased risk of hyponatremia
Emergency

Balanced intravenous solutions reduce risk of hyperchloremia in the pediatric intensive care unit

January 5, 2023
#VisualAbstract: Restriction of Intravenous Fluids in ICU Patients with Septic Shock
StudyGraphics

#VisualAbstract: Restriction of Intravenous Fluids in ICU Patients with Septic Shock

July 8, 2022
#VisualAbstract: Intravenous vitamin C increases mortality and organ dysfunction in sepsis patients
StudyGraphics

#VisualAbstract: Intravenous vitamin C increases mortality and organ dysfunction in sepsis patients

July 7, 2022
Hypotonic IVF linked to increased risk of hyponatremia
Emergency

Intravenous fluid restriction does not improve septic shock outcomes

June 27, 2022
Next Post
Quick Take: Risankizumab compared with adalimumab in patients with moderate-to-severe plaque psoriasis (IMMvent)

Bimekizumab superior to secukinumab for plaque psoriasis treatment

UTI associated with increased risk of preeclampsia

Ambulatory blood pressure monitoring remains the reference standard for hypertension screening over office-based measurement: US Preventive Services Task Force

Asymptomatic women at high risk for Multiple Sclerosis may have early subclinical neuroimaging abnormalities

Improvements in therapeutic and managing standards associated with significant reduction in risk of persistent disability in patients with pediatric-onset multiple sclerosis

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • BNT162b2 booster is safe and reduces COVID-19 transmission in older adults
  • Bisphosphonates, denosumab, abaloparatide, teriparatide, and romosozumab reduce postmenopausal fracture risk
  • Epstein-Barr viral load monitoring reduces risk of post-liver transplant lymphoproliferative disease
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • The Scan
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

Want more physician-written
medical news?

Join over 10 million yearly readers and numerous companies. For healthcare professionals
and the public.

Subscribe for free today!

Subscription options