Decrease in Mortality after the Implementation of a Hospital Model to Improve Performance in Sepsis Care: Princess Sepsis Code

Author:

Méndez Rosa1,Figuerola Angels2,Ramasco Fernando1ORCID,Chicot Marta3ORCID,Pascual Natalia F.4ORCID,García Íñigo5,von Wernitz Andrés6,Zurita Nelly D.7,Semiglia Auxiliadora7,Pizarro Alberto6,Saez Carmen8,Rodríguez Diego9ORCID

Affiliation:

1. Department of Anaesthesiology and Surgical Intensive Care, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

2. Department of Preventive Medicine and Public Health, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

3. Department of Intensive Care Medicine, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

4. Department of Clinical Analysis, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

5. Department of General Surgery, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

6. Department of Emergency, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

7. Department of Microbiology, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

8. Department of Internal Medicine, Hospital Universitario de La Princesa, Diego de León 62, 28006 Madrid, Spain

9. Department of Intensive Care Medicine, Hospital Universitario Príncipe de Asturias, Avenida Principal de La Universidad s/n, 28805 Madrid, Spain

Abstract

Sepsis is a time-dependent disease whose prognosis is influenced by early diagnosis and therapeutic measures. Mortality from sepsis remains high, and for this reason, the guidelines of the Surviving Sepsis Campaign recommend establishing specific care programs aimed at patients with sepsis. We present the results of the application of a hospital model to improve performance in sepsis care, called Princess Sepsis Code, with the aim of reducing mortality. A retrospective study was conducted using clinical, epidemiological, and outcome variables in patients diagnosed with sepsis from 2015 to 2022. A total of 2676 patients were included, 32% of whom required admission to the intensive care unit, with the most frequent focus of the sepsis being abdominal. Mortality in 2015, at the beginning of the sepsis code program, was 24%, with a declining rate noted over the study period, with mortality reaching 17% in 2022. In the multivariate analysis, age > 70 years, respiratory rate > 22 rpm, deterioration in the level of consciousness, serum lactate > 2 mmol/L, creatinine > 1.6 mg/dL, and the focus of the sepsis were identified as variables independently related to mortality. The implementation of the Princess Sepsis Code care model reduces the mortality of patients exhibiting sepsis and septic shock.

Publisher

MDPI AG

Subject

Medicine (miscellaneous)

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