Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis).
Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis).
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DOI：
10.1136/bmjopen-2020-041022
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发表时间：
2021-02-18
期刊：
影响因子：
2.9
通讯作者：
Limmathurotsakul D
中科院分区：
文献类型：
--
作者：
Booraphun S;Hantrakun V;Siriboon S;Boonsri C;Poomthong P;Singkaew BO;Wasombat O;Chamnan P;Champunot R;Rudd K;Day NPJ;Dondorp AM;Teparrukkul P;West TE;Limmathurotsakul D
评价2015年1月在泰国一家区域转诊医院启动的脓毒症快速通道（SFT）项目的有效性。使用2013年3月至2017年1月的前瞻性观察性研究（Ubon-脓毒症）数据进行的回顾性分析。研究医院的普通内科病房和重症监护室（ICU）。在Ubon败血症队列中观察到的社区获得性败血症患者。脓毒症定义为改良序贯器官衰竭评估（SOFA）评分≥2。SFT计划是一项在入院时识别和启动脓毒症护理的方案，于2015年在研究医院实施。SFT项目中的患者在可用时直接进入ICU。非暴露组由接受标准治疗的患者组成。主要结局为28天死亡率。次要结局是测量脓毒症管理干预。在3806例脓毒症患者中，903例（24%）被检测并入组研究医院的SFT项目（SFT组），2903例接受标准治疗（非暴露组）。SFT组的患者有更多的器官功能障碍，更有可能接受严格的脓毒症管理，并直接进入ICU（19% vs 4%）。SFT组患者更有可能存活（校正HR 0.72，95% CI 0.58至0.88，p=0.001），校正了入院年份、性别、年龄、合并症、改良SOFA评分和直接入住ICU。SFT计划与改善脓毒症护理和降低泰国农村脓毒症患者的死亡风险有关，因为那里的一些重症护理资源有限。即使所有参加该计划的患者不能直接进入ICU，也可以观察到生存益处。NCT02217592。
To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015. A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017. General medical wards and medical intensive care units (ICUs) of a study hospital. Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2. The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care. The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions. Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs. The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs. NCT02217592.
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DOI：
10.1001/jama.2016.0288
发表时间：
2016-02-23
期刊：
JAMA
影响因子：
--
作者：
Seymour CW;Liu VX;Iwashyna TJ;Brunkhorst FM;Rea TD;Scherag A;Rubenfeld G;Kahn JM;Shankar-Hari M;Singer M;Deutschman CS;Escobar GJ;Angus DC
通讯作者：
Angus DC
影响因子：
8.8
作者：
Jacob ST;Banura P;Baeten JM;Moore CC;Meya D;Nakiyingi L;Burke R;Horton CL;Iga B;Wald A;Reynolds SJ;Mayanja-Kizza H;Scheld WM;Promoting Resource-Limited Interventions for Sepsis Management in Uganda Study Group
通讯作者：
Promoting Resource-Limited Interventions for Sepsis Management in Uganda Study Group
影响因子：
3.7
作者：
Hantrakun, Viriya;Somayaji, Ranjani;Limmathurotsakul, Direk
通讯作者：
Limmathurotsakul, Direk
影响因子：
7.1
作者：
Rudd, Kristina E.;Hantrakun, Viriya;West, T. Eoin
通讯作者：
West, T. Eoin
影响因子：
3.7
作者：
Teparrukkul, Prapit;Hantrakun, Viriya;Limmathurotsakul, Direk
通讯作者：
Limmathurotsakul, Direk