Outcome of the Surin Sepsis Treatment Protocol in Sepsis Management

Abstract

Background and Objective: Infections and sepsis are global public health problems. Factors related to mortality are delayed diagnosis, non-intensive care setting admission, delayed antibiotic administration more than three hours, inadequate antibiotics dosage and multi-organ failure. Surviving Sepsis Campaign (SSC) and early goal-directed therapy (EGDT) have been reported to decrease morbidity and mortality from sepsis. Therefore these evidence-based protocols were adapted and applied to sepsis management practice in Surin Hospital. This study aim to compare mortality rate and outcome of treatment process before and after the  Surin sepsis treatment protocol was implemented.

Methods: This study is intervention study. Data from 30 patients  were retrieved during April 1st to September 30th, 2009 comparing with those of 30 patients during January 1st to June 30th, 2010. Data collection comprised of patients’ demographic data, treatment process in the first six hours and outcomes of treatment.

Results: After the Surin sepsis treatment protocol was applied to practice; fluid replacement therapy and culture/sensitivity tests before antibiotics prescription were higher than the period before protocol was implemented. Rate of fluid replacement significantly increased from 76.7% to 96.7% (p = 0.023) and rate of culture/sensitivity test before antibiotics prescription significantly increased from 56.7% to 90.0% (p = 0.004). Outcomes of treatment; mortality rate was decreased from 43.3% to 20.0% (non-significant p = 0.159) and hospital length of stay increased from 3.33 to 4.47 days (non-significant p = 0.495). Cost of treatment increased from 11,547 to 12,999 baht.

Conclusion: The developed sepsis treatment protocol resulted in targeted and prompt treatment initiation. Patient was assigned the appropriate critical care and antibiotics dosing regimen. Consequently the mortality is therefore decreased.

Key words: Sepsis Treatment protocol