دورية أكاديمية
أعرض في EDS

Order Set Usage is Associated With Lower Hospital Mortality in Patients With Sepsis.

التفاصيل البيبلوغرافية
العنوان: Order Set Usage is Associated With Lower Hospital Mortality in Patients With Sepsis.
المؤلفون: Dale CR; Swedish Health Services, Seattle, WA.; School of Public Health, University of Washington, Seattle, WA., Schoepflin Sanders S; Providence St. Vincent Medical Center, Portland, OR., Chang SC; Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Portland, OR.; Providence Research Network, Renton, WA., Pandhair O; Providence St. Vincent Medical Center, Portland, OR., Diggs NG; Swedish Health Services, Seattle, WA., Woodruff W; Providence, Renton, WA., Selander DN; Swedish Health Services, Seattle, WA., Mark NM; Swedish Health Services, Seattle, WA., Nurse S; Providence, Renton, WA., Sullivan M; Swedish Health Services, Seattle, WA., Mezaraups L; Providence, Renton, WA., O'Mahony DS; Swedish Health Services, Seattle, WA.; Department of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA.
المصدر: Critical care explorations [Crit Care Explor] 2023 May 16; Vol. 5 (5), pp. e0918. Date of Electronic Publication: 2023 May 16 (Print Publication: 2023).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]-
مستخلص: The Surviving Sepsis Campaign recommends standard operating procedures for patients with sepsis. Real-world evidence about sepsis order set implementation is limited.
Objectives: To estimate the effect of sepsis order set usage on hospital mortality.
Design: Retrospective cohort study.
Setting and Participants: Fifty-four acute care hospitals in the United States from December 1, 2020 to November 30, 2022 involving 104,662 patients hospitalized for sepsis.
Main Outcomes and Measures: Hospital mortality.
Results: The sepsis order set was used in 58,091 (55.5%) patients with sepsis. Initial mean sequential organ failure assessment score was 0.3 lower in patients for whom the order set was used than in those for whom it was not used (2.9 sd [2.8] vs 3.2 [3.1], p < 0.01). In bivariate analysis, hospital mortality was 6.3% lower in patients for whom the sepsis order set was used (9.7% vs 16.0%, p < 0.01), median time from emergency department triage to antibiotics was 54 minutes less (125 interquartile range [IQR, 68-221] vs 179 [98-379], p < 0.01), and median total time hypotensive was 2.1 hours less (5.5 IQR [2.0-15.0] vs 7.6 [2.5-21.8], p < 0.01) and septic shock was 3.2% less common (22.0% vs 25.4%, p < 0.01). Order set use was associated with 1.1 fewer median days of hospitalization (4.9 [2.8-9.0] vs 6.0 [3.2-12.1], p < 0.01), and 6.6% more patients discharged to home (61.4% vs 54.8%, p < 0.01). In the multivariable model, sepsis order set use was independently associated with lower hospital mortality (odds ratio 0.70; 95% CI, 0.66-0.73).
Conclusions and Relevance: In a cohort of patients hospitalized with sepsis, order set use was independently associated with lower hospital mortality. Order sets can impact large-scale quality improvement efforts.
Competing Interests: The authors declare that they are or were employees of Providence and its affiliates and have no other real or perceived conflicts of interest.
(Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.)
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فهرسة مساهمة: Keywords: clinical decision support; health services; order set; quality improvement; sepsis
تواريخ الأحداث: Date Created: 20230519 Latest Revision: 20230522
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC10191554
DOI: 10.1097/CCE.0000000000000918
PMID: 37206374
قاعدة البيانات: MEDLINE
الوصف
تدمد:2639-8028
DOI:10.1097/CCE.0000000000000918