The Impact of Hour-1 Sepsis Bundle Compliance on 30-day Mortality among Adult with Community-acquired Sepsis and Septic Shock in Phanatnikhom Hospital
Abstract
INTRODUCTION: Hour-1 Sepsis Bundle is recommended in Surviving Sepsis Campaign (SSC) Guideline 2018. Latest update of SSC guideline was revised and released in 2021. Many studies have shown lower mortality in compliance with Hour-3 Sepsis bundle, but supporting evidence on Hour-1 Sepsis bundle were scarcely published. The study was conducted to evaluate the impact of Hour-1 Sepsis bundle compliance on mortality in patients with community-acquired sepsis and septic shock in Phanatnikhom Hospital, a middle level referral hospital in Chonburi, Thailand.
METHODS: This retrospective cohort study aimed to evaluate the impact on 30-day mortality between sepsis patients who complete Hour-1 Sepsis bundle and those who do not. The patients age > 18 year with community-acquired sepsis and septic shock from October 2020 to September 2021 were included in the study. The compliance of all bundles was evaluated and compared its effect on 30-day mortality.
RESULTS: 148 Patients were enrolled in the study. There were 59 patients in complete Hour-1 bundle group (39.9%) and 89 patients in incomplete Hour-1 bundle group (60.1%). 30-day mortality was 16.9% and 50.6% in complete and incomplete Hour-1 bundle group respectively (OR=5.0, P < 0.001). Logistic regression analysis showed significant association between complete Hour-1 bundle and mortality (adjusted OR=3.4, P=0.01).
CONCLUSION: The complete Hour-1 Sepsis Bundle was significantly decreased 30-day mortality but compliance rate on Hour-1 Bundle still low. Completion of all Hour-1 Sepsis Bundle should be emphasized to improve treatment outcome
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