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Relationship between time of emergency department admission and adherence to the Surviving Sepsis Campaign bundle in patients with septic shock

Authors
 Je Sung You  ;  Yoo Seok Park  ;  Sung Phil Chung  ;  Hye Sun Lee  ;  Soyoung Jeon  ;  Won Young Kim  ;  Tae Gun Shin  ;  You Hwan Jo  ;  Gu Hyun Kang  ;  Sung Hyuk Choi  ;  Gil Joon Suh  ;  Byuk Sung Ko  ;  Kap Su Han  ;  Jong Hwan Shin  ;  Taeyoung Kong 
Citation
 CRITICAL CARE, Vol.26(1) : 43, 2022-02 
Journal Title
CRITICAL CARE
ISSN
 1364-8535 
Issue Date
2022-02
MeSH
Emergency Service, Hospital ; Guideline Adherence ; Hospital Mortality ; Humans ; Prospective Studies ; Sepsis* / therapy ; Shock, Septic* / therapy
Keywords
Off-hour effect ; Sepsis ; Septic shock ; Surviving Sepsis Campaign
Abstract
Background: Nighttime hospital admission is often associated with increased mortality risk in various diseases. This study investigated compliance rates with the Surviving Sepsis Campaign (SSC) 3-h bundle for daytime and nighttime emergency department (ED) admissions and the clinical impact of compliance on mortality in patients with septic shock.

Methods: We conducted an observational study using data from a prospective, multicenter registry for septic shock provided by the Korean Shock Society from 11 institutions from November 2015 to December 2017. The outcome was the compliance rate with the SSC 3-h bundle according to the time of arrival in the ED.

Results: A total of 2049 patients were enrolled. Compared with daytime admission, nighttime admission was associated with higher compliance with the administration of antibiotics within 3 h (adjusted odds ratio (adjOR), 1.326; 95% confidence interval (95% CI), 1.088-1.617, p = 0.005) and with the complete SSC bundle (adjOR, 1.368; 95% CI, 1.115-1.678; p = 0.003), likely to result from the increased volume of all patients and sepsis patients admitted during daytime hours. The hazard ratios of the completion of SSC bundle for 28-day mortality and in-hospital mortality were 0.750 (95% CI 0.590-0.952, p = 0.018) and 0.714 (95% CI 0.564-0.904, p = 0.005), respectively.

Conclusion: Septic shock patients admitted to the ED during the daytime exhibited lower sepsis bundle compliance than those admitted at night. Both the higher number of admitted patients and the higher patients to medical staff ratio during daytime may be factors that are responsible for lowering the compliance.
Files in This Item:
T202200695.pdf Download
DOI
10.1186/s13054-022-03899-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
Yonsei Authors
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188265
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