An algorithm of good clinical practice to reduce intra-hospital 90-day mortality and need for Intensive Care Unit transfer: a new approach for septic patient management

摘要

Sepsis accounts for 50% of intrahospital mortality Septic shock is diagnosed in 2% of patients with half of these needing for Intensive Care Unit (ICU) transfer An algorithm was applied for mortality, need for intensive care transfer and length of stay decrease The observational study was performed on 231 consecutive enrolled patients with sepsis or septic shock admitted to the University Campus BioMedico of Rome The algorithm was based on good clinical practice application of antimicrobial stewardship Data were compared with data from comparable population of National and European surveys In the study group, the global mortality rate was 268% (39% was intrahospital and 23% 90d mortality), need of ICU transfer was registered in 216%, and the median length of stay was 15 days Globally, intrahospital and 90day mortality, were significantly lower than at national level (268% vs 636%, P00001; 39% vs 25%, P00001 and 23% vs 375%, P=00092) Need for ICU transfer in patients with septic shock was significantly lower than in the English survey (319% by vs 808% P00001) A significant decrease of intrahospital, 90d mortality and need of ICU transfer was achieved.