SEPSIS: REDUCING MORTALITY IN SURGICAL PATIENTS

Objectives: While Sepsis mortality’s remains high ( about 30% ) , efforts to reduce it by implementing various measures are continuing. The recent CDC guideline
are promising. We collected data from our Sepsis patients presented to the Emergency Department (ED) with sepsis and looked at their mortality and morbidity after being treated with new protocol and compared it to earlier patients with sepsis before implementation of the protocol.

Methods: A retrospective analysis of 1079 patients seen in the ED with sepsis during 2018 and 2020, before and after implementation of the new CDC protocol.
The data collected included: age ,gender, race, length of stay, co-morbid conditions, mortality and therapy received. Statistical analysis using student’s t-test and Chi square test as well as cox regression analysis to determine the cofounding factors that may influence survival. The patients divided in to two groups: pre protocol (group 1) and post protocol ( group2). IRB approval was obtained prior to the study.

Results: A total of 1079 patients were included in the study. The mean age was 65 +- 16.86 years, divided equally between gender ( male 49%, female 51%).
Mean hospital length of stay were similar in both groups ( 9 days ) , however mortality in group 1 ( pre protocol) were 12.3% vs 9.1% ( p = 0.08), however patients with coronary artery diseases , chronic obstructive pulmonary diseases as well as chronic kidney diseases all showed statistically significant survival rate in the protocol group. The mortality rate of surgical patients were improved by 1% and of the medical patients by 4%.

Conclusion: The current protocol for sepsis when implemented will improve patients survival, in both surgical and medical patients and significantly in those with co-morbid conditions.