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Impact of timing to source control in patients with septic shock: A prospective multi-center observational study

Authors
 Hongjung Kim  ;  Sung Phil Chung  ;  Sung-Hyuk Choi  ;  Gu Hyun Kang  ;  Tae Gun Shin  ;  Kyuseok Kim  ;  Yoo Seok Park  ;  Kap Su Han  ;  Han Sung Choi  ;  Gil Joon Suh  ;  Won Young Kim  ;  Tae Ho Lim  ;  Byuk Sung Ko  ;  for the Korean Shock Society (KoSS) Investigators 
Citation
 JOURNAL OF CRITICAL CARE, Vol.53 : 176-182, 2019 
Journal Title
 JOURNAL OF CRITICAL CARE 
ISSN
 0883-9441 
Issue Date
2019
Keywords
Emergency service ; Hospital ; Infection control ; Septic shock
Abstract
PURPOSE: Current guidelines recommend that rapid source control should be adopted in patients not >6-12 h after sepsis is diagnosed. However, evidence level of this guideline is not specified, and there is no previous study on patients with septic shock visiting the emergency department (ED). Therefore, we aimed to assess the impact of rapid source control in patients with septic shock visiting the ED. MATERIALS AND METHODS: In a prospective, observational, multicenter, registry-based study in 11 EDs, Cox proportional hazards model was used to assess the independent effect of source control and time to source control on 28-day mortality. RESULTS: Cox proportional hazard models revealed that 28-day mortality was significantly lower in patients who underwent source control (HR 0.538 (0.389-0.744), p < .001). However, no significant association between the performance of source control after 6 h or 12 h from enrollment and 28-day mortality was noted. CONCLUSIONS: Patients with septic shock visiting the ED who underwent source control showed better outcomes than those who did not. We failed to demonstrate the performance of rapid source control reduced the 28-day mortality in septic shock patients. Further studies are required to determine the impact of rapid source control in sepsis and septic shock.
Full Text
https://www.sciencedirect.com/science/article/pii/S0883944119303144
DOI
10.1016/j.jcrc.2019.06.012
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174756
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