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实施医院模式以改善脓毒症护理绩效后的死亡率下降:公主脓毒症代码。

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

作者信息

Méndez Rosa, Figuerola Angels, Ramasco Fernando, Chicot Marta, Pascual Natalia F, García Íñigo, von Wernitz Andrés, Zurita Nelly D, Semiglia Auxiliadora, Pizarro Alberto, Saez Carmen, Rodríguez Diego

机构信息

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

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

出版信息

J Pers Med. 2024 Jan 29;14(2):149. doi: 10.3390/jpm14020149.

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 , 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.

摘要

脓毒症是一种与时间相关的疾病,其预后受早期诊断和治疗措施的影响。脓毒症导致的死亡率仍然很高,因此,“拯救脓毒症运动”指南建议针对脓毒症患者建立特定的护理计划。我们展示了一种名为“公主脓毒症代码”的医院模型在改善脓毒症护理绩效方面的应用结果,旨在降低死亡率。我们使用2015年至2022年诊断为脓毒症患者的临床、流行病学和结局变量进行了一项回顾性研究。共纳入2676例患者,其中32%需要入住重症监护病房,脓毒症最常见的发病部位是腹部。在脓毒症代码计划开始的2015年,死亡率为24%,在研究期间呈下降趋势,2022年死亡率降至17%。在多变量分析中,年龄>70岁、呼吸频率>22次/分钟、意识水平恶化、血清乳酸>2 mmol/L、肌酐>1.6 mg/dL以及脓毒症的发病部位被确定为与死亡率独立相关的变量。“公主脓毒症代码”护理模型的实施降低了脓毒症和脓毒性休克患者的死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d9c/10890463/defbd645af96/jpm-14-00149-g001.jpg

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