Author:
Hyun Dong-gon,Lee Su Yeon,Ahn Jee Hwan,Huh Jin Won,Hong Sang-Bum,Koh Younsuck,Lim Chae-Man,Oh Dong Kyu,Suh Gee Young,Jeon Kyeongman,Ko Ryoung-Eun,Cho Young-Jae,Lee Yeon Joo,Lim Sung Yoon,Park Sunghoon,Heo Jeongwon,Lee Jae-myeong,Kim Kyung Chan,Lee Yeon Joo,Chang Youjin,Jeon Kyeongman,Lee Sang-Min,Hong Suk-Kyung,Cho Woo Hyun,Kwak Sang Hyun,Lee Heung Bum,Ahn Jong-Joon,Seong Gil Myeong,Lee Song-I,Park Sunghoon,Park Tai Sun,Lee Su Hwan,Choi Eun Young,Moon Jae Young,
Abstract
Abstract
Background
Hospital-onset sepsis is associated with a higher in-hospital mortality rate than community-onset sepsis. Many hospitals have implemented rapid response teams (RRTs) for early detection and timely management of at-risk hospitalized patients. However, the effectiveness of an all-day RRT over a non-all-day RRT in reducing the risk of in-hospital mortality in patient with hospital-onset sepsis is unclear. We aimed to determine the effect of the RRT’s operating hours on in-hospital mortality in inpatient patients with sepsis.
Methods
We conducted a nationwide cohort study of adult patients with hospital-onset sepsis prospectively collected from the Korean Sepsis Alliance (KSA) Database from 16 tertiary referral or university-affiliated hospitals in South Korea between September of 2019 and February of 2020. RRT was implemented in 11 hospitals, of which 5 (45.5%) operated 24-h RRT (all-day RRT) and the remaining 6 (54.5%) had part-day RRT (non-all-day RRT). The primary outcome was in-hospital mortality between the two groups.
Results
Of the 405 patients with hospital-onset sepsis, 206 (50.9%) were admitted to hospitals operating all-day RRT, whereas 199 (49.1%) were hospitalized in hospitals with non-all-day RRT. A total of 73 of the 206 patients in the all-day group (35.4%) and 85 of the 199 patients in the non-all-day group (42.7%) died in the hospital (P = 0.133). After adjustments for co-variables, the implementation of all-day RRT was associated with a significant reduction in in-hospital mortality (adjusted odds ratio 0.57; 95% confidence interval 0.35–0.93; P = 0.024).
Conclusions
In comparison with non-all-day RRTs, the availability of all-day RRTs was associated with reduced in-hospital mortality among patients with hospital-onset sepsis.
Funder
Korea Disease Control and Prevention Agency
Publisher
Springer Science and Business Media LLC
Subject
Critical Care and Intensive Care Medicine
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