The Treatment Outcome of Community-Acquired Sepsis in Chonburi Hospital
Abstract
Community-acquired sepsis is a serious condition with high mortality rate worldwide. Efforts had been put to improve treatment outcome of such condition. In 2016, the Sepsis-3 definition was developed and then the new sepsis care bundle with 5 elements in 2018 which also implemented in Chonburi hospital. In Thailand, Ministry of Public Health set target to decrease mortality rate to below 30%. However, published clinical trials using Sepsis-3 definition and sepsis care bundle to evaluate treatment outcome in Thailand were scarce. We retrospectively enrolled patients with community-acquired sepsis defined by Sepsis-3 who were admitted to medicine ward, Chonburi hospital. Medical charts were reviewed, clinical data were recorded and analyzed.
Between April 1st and May 31st, 2018, a total of 112 patients with confirmed diagnosis of community-acquired sepsis were enrolled. The mortality rate was 42% (95% CI 32.7-51.7). Bacteremia was found in 52.7% (95% CI 43.0-62.2) of patients and 32.2% (95% CI 20.6-45.6) of them had antimicrobial resistant bacterial infection. Compliance to sepsis care bundle was over 80% except for intravenous fluid resuscitation which complied 48.8% (95% CI 37.6-60.1). Overall, fully compliance rate was 44.6% (95% CI 35.2-54.3). Complete all elements of sepsis care bundle was the only factor associated with decrease mortality with statistical significance, odds ratio 2.926 (95% CI 1.32-6.47: P-value = 0.008).
In summary, the hospital mortality rate of community-acquired sepsis patients admitted to medicine ward, Chonburi hospital was higher than targeted. Improvement of sepsis car bundle compliance is critical to decrease mortality rate.
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