The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock

Arabi, Yaseen M.; Al-Dorzi, Hasan M.; Alamry, Ahmed; Hijazi, Ra’ed; Alsolamy, Sami; Al Salamah, Majid; Tamim, Hani M.; Al-Qahtani, Saad; Al-Dawood, Abdulaziz; Marini, Abdellatif M.; Al Ehnidi, Fatimah H.; Mundekkadan, Shihab; Matroud, Amal; Mohamed, Mohamed S.; Taher, Saadi

doi:10.1186/s13613-017-0280-7

Annals of Intensive Care

Table 1 Baseline characteristics of patients with sepsis and septic shock on presentation in the three study phases: pre-intervention (A), intervention phase I (B) and intervention phase II (C)

From: The impact of a multifaceted intervention including sepsis electronic alert system and sepsis response team on the outcomes of patients with sepsis and septic shock

All patients	Pre-intervention A	Intervention phase I B	Intervention phase II C	Crude p value			p value after propensity score adjustment
All patients	N = 436	N = 195	N = 699	B vs. A	C vs. B	C vs. A	B vs. A	C vs. B	C vs. A
Source of sepsis, no. (%)
Pneumonia	228 (52.3)	93 (47.7)	281 (40.2)	0.29	0.06	<0.0001	0.99	0.98	0.96
Urinary tract infection	70 (16.1)	28 (14.4)	107 (15.3)	0.59	0.74	0.74	0.78	0.90	0.38
Acute abdominal infection	40 (9.2)	8 (3.6)	47 (6.7)	0.03	0.18	0.13	0.05	0.37	0.17
Soft tissue infection	8 (1.8)	8 (4.1)	32 (4.6)	0.10	0.78	0.01	0.42	0.84	0.56
Other infections	138 (31.7)	68 (34.9)	254 (36.3)	0.43	0.71	0.11	0.92	0.60	0.48
Signs and symptoms, no. (%)
Hyperthermia^a	114 (26.2)	52 (26.7)	172 (24.6)	0.89	0.56	0.56	0.81	0.15	0.47
Hypothermia^a	34 (7.8)	6 (3.1)	7 (1.0)	0.02	0.04	<0.0001	0.99	0.86	0.81
Acutely altered mental status	157 (36.0)	48 (24.6)	59 (8.4)	0.005	<0.0001	<0.0001	0.98	0.67	0.71
Chills and rigors	11 (2.5)	7 (3.6)	2 (0.3)	0.46	0.001	0.0006	0.55	0.0007	0.02
Tachycardia^a	354 (81.2)	168 (86.2)	624 (89.3)	0.13	0.23	0.0001	0.76	0.44	0.49
Tachypnea^a	368 (84.4)	174 (89.2)	583 (83.4)	0.11	0.05	0.66	0.44	0.34	0.92
Hypotension^a	368 (84.4)	111 (56.9)	265 (37.9)	<0.0001	<0.0001	<0.0001	0.004	0.42	<0.0001
Hypoxia^a	101 (23.2)	79 (40.5)	227 (32.5)	<0.0001	0.04	0.0008	0.94	0.96	0.99
Laboratory findings, no. (%)
Leukocytosis^a	237 (54.4)	85 (43.6)	229 (32.8)	0.01	0.005	<0.0001	0.14	0.003	<0.0001
Leukopenia^a	36 (8.3)	6 (3.1)	21 (3.0)	0.02	0.96	<0.0001	0.99	0.99	0.92
Increased creatinine^a	107 (24.5)	4 (2.1)	1 (0.1)	<0.0001	0.009	<0.0001	0.97	0.99	0.68
Thrombocytopenia^a	40 (9.2)	0 (0.0)	1 (0.1)	<0.0001	1.0	<0.0001	0.43	0.99	0.70
Hyperbilirubinemia^a	44 (10.1)	1 (0.5)	1 (0.1)	<0.0001	0.39	<0.0001	0.82	0.94	0.68
Hyperlactatemia^a	168 (38.5)	70 (35.9)	320 (45.8)	0.53	0.01	0.02	0.99	0.99	0.98
Coagulopathy^a	67 (15.4)	2 (1.0)	1 (0.1)	<0.0001	0.12	<0.0001	0.87	0.86	0.67
Classification, no. (%)
Sepsis	108 (24.8)	99 (50.8)	584 (83.6)	<0.0001	<0.0001	<0.0001	0.93	0.78	0.68
Septic shock	328 (75.2)	96 (49.2)	115 (16.5)

^aHyperthermia: temperature >38 °C, hypothermia: temperature <36 °C, tachycardia: heart rate >90/min, tachypnea: respiratory rate >20/min, hypotension: systolic blood pressure <90, mean arterial pressure <65 or systolic blood pressure decrease >40 mmHg from baseline, hypoxia: oxygen requirement to maintain oxygen saturation >90%, leukocytosis: WBC count >12 × 10⁹/L, leucopenia: white blood cell count <4 × 10⁹/L, increased creatinine: creatinine increase >176.8 mmol/L, thrombocytopenia: platelet count <100 × 10⁹/L, hyperbilirubinemia: bilirubin >34.2 mmol/L, hyperlactatemia: lactate >2 mmol/L, coagulopathy: international normalized ratio (INR) >1

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