Data from: An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: an observational cohort study
Amland, Robert C.; Sutariya, Bharat B. (2019), Data from: An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: an observational cohort study, Dryad, Dataset, https://doi.org/10.5061/dryad.gt5m884
Objective. To determine the prevalence of initiating the sepsis 3-hour bundle of care and estimate effects of bundle completion on risk-adjusted mortality among ED patients screened-in by electronic surveillance. Materials and Methods. This was a multiple center observational cohort study conducted in 2016. The study population was comprised of patients screened-in by St. John Sepsis Surveillance Agent within four hours of ED arrival, had a sepsis bundle initiated, and admitted to hospital. We built multivariable logistic regression models to estimate impact of a 3-hour bundle completed within three hours of arrival on mortality outcomes. Results. Approximately 3% ED patients were screened-in by electronic surveillance within four hours of arrival and admitted to hospital. Nearly 7 in 10 (69%) patients had a bundle initiated, with most bundles completed within three hours of arrival. The fully-adjusted risk model achieved good discrimination on mortality outcomes (AUROC = .82, 95% CI = .79 to .85) and estimated 34% reduced mortality risk among patients with a bundle completed within three hours of arrival compared to non-completers. Discussion. The sepsis bundle is an effective intervention for many vulnerable patients, and likely to be completed within three hours after arrival when electronic surveillance with reliable alert notifications are integrated into clinical workflow. Beginning at triage, the platform and sepsis program enables identification and management of patients with greater precision, and increases the odds of good outcomes. Conclusion. Sepsis surveillance and clinical decision support accelerate accurate recognition and stratification of patients, and facilitate timely delivery of healthcare.