Méndez R, Figuerola A, Chicot M, Barrios A, Pascual N, Ramasco F, Rodríguez D, García I, von Wernitz A, Zurita N, Semiglia A, Jiménez D, Navarro S, Rubio M J, Vinuesa M, Del Campo L, Bautista A, Pizarro A
Rosa Méndez Hernández. Servicio de Anestesia y Reanimación. Hospital Universitario de La Princesa. Calle Diego de León 62. 28006. Madrid, Spain.
Rev Esp Quimioter. 2022 Feb;35(1):43-49. doi: 10.37201/req/105.2021. Epub 2021 Nov 23.
In the hospital of La Princesa, the "Sepsis Code" (CSP) began in 2015, as a multidisciplinary group that provides health personnel with clinical, analytical and organizational tools, with the aim of the detection and early treatment of patients with sepsis. The objective of this study is to evaluate the impact of CSP implantation on mortality and to determine the variables associated with an increase in it.
A retrospective analytical study of patients with CSP alert activation from 2015 to 2018 was conducted. Clinical-epidemiological variables, analytical parameters, and severity factors such as admission to critical care units (UCC) and the need for amines were collected. Statistical significance was established at p < 0.05.
We included 1,121 patients. The length of stay was 16 days and 32% required admission to UCC. Mortality showed a statistically significant linear downward trend from 24% in 2015 to 15% in 2018. The predictive mortality variables with statistically significant association were lactate > 2 mmol/L, creatinine > 1.6 mg/dL and the need for amines.>5.0%, mortality at the time of chart review 62.0%, and 6-months-post-discharge readmission 47.7%.
The implementation of Sepsis Code decreases the mortality of patients with sepsis and septic shock. The presence of a lactate > 2 mmol/L, creatinine > 1.6 mg/dL and/or the need to administer amines in the first 24 hours, are associated with an increase in mortality in the patient with sepsis.
在拉普林塞萨医院，“脓毒症代码”（CSP）于2015年启动，作为一个多学科团队，为医护人员提供临床、分析和组织工具，旨在检测和早期治疗脓毒症患者。本研究的目的是评估CSP实施对死亡率的影响，并确定与之增加相关的变量。
对2015年至2018年CSP警报激活的患者进行回顾性分析研究。收集临床流行病学变量、分析参数以及严重程度因素，如入住重症监护病房（UCC）和使用胺类药物的需求。以p < 0.05确定统计学意义。
我们纳入了1121例患者。住院时间为16天，32%的患者需要入住UCC。死亡率呈现出统计学上显著的线性下降趋势，从2015年的24%降至2018年的15%。具有统计学显著关联的预测死亡变量为乳酸>2 mmol/L、肌酐>1.6 mg/dL以及使用胺类药物的需求。>5.0%，病历审查时的死亡率为62.0%，出院后6个月再入院率为47.7%。
脓毒症代码的实施降低了脓毒症和脓毒性休克患者的死亡率。乳酸>2 mmol/L、肌酐>1.6 mg/dL和/或在最初24小时内需要使用胺类药物与脓毒症患者死亡率增加相关。
