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Impact of 1-Hour Bundle Achievement in Septic Shock

Authors
 Byuk Sung Ko  ;  Sung-Hyuk Choi  ;  Tae Gun Shin  ;  Kyuseok Kim  ;  You Hwan Jo  ;  Seung Mok Ryoo  ;  Yoo Seok Park  ;  Woon Yong Kwon  ;  Han Sung Choi  ;  Sung Phil Chung  ;  Gil Joon Suh  ;  Hyunggoo Kang  ;  Tae Ho Lim  ;  Donghee Son  ;  Won Young Kim 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.10(3) : 527, 2021-02 
Journal Title
 JOURNAL OF CLINICAL MEDICINE 
Issue Date
2021-02
Keywords
1-h bundle ; emergency department ; mortality ; outcome ; sepsis ; septic shock
Abstract
This study aimed to address the impact of 1-hr bundle achievement on outcomes in septic shock patients. Secondary analysis of multicenter prospectively collected data on septic shock patients who had undergone protocolized resuscitation bundle therapy at emergency departments was conducted. In-hospital mortality according to 1-h bundle achievement was compared using multivariable logistic regression analysis. Patients were also divided into 3 groups according to the time of bundle achievement and outcomes were compared to examine the difference in outcome for each group over time: group 1 (≤1 h reference), group 2 (1-3 h) and group 3 (3-6 h). In total, 1612 patients with septic shock were included. The 1-h bundle was achieved in 461 (28.6%) patients. The group that achieved the 1-h bundle did not show a significant difference in in-hospital mortality compared to the group that did not achieve the 1-h bundle on multivariable logistic regression analysis (<1 vs. >1 h) (odds ratio = 0.74, p = 0.091). However, 3- and 6- h bundle achievements showed significantly lower odds ratios of in-hospital mortality compared to the group that did not achieve the bundle (<3 vs. >3 h, <6 vs. >6 h, odds ratio = 0.604 and 0.458, respectively). There was no significant difference in in-hospital mortality over time for group 2 and 3 compared to that of group 1. One-hour bundle achievement was not associated with improved outcomes in septic shock patients. These data suggest that further investigation into the clinical implications of 1-h bundle achievement in patients with septic shock is warranted.
DOI
10.3390/jcm10030527
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/22282913/182959
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