Internal Medicine, Division of Hospital Medicine, Lankenau Medical Center, Wynnewood, PA, USA.
Postgrad Med. 2024 Sep;136(7):702-711. doi: 10.1080/00325481.2024.2388021. Epub 2024 Aug 7.
Sepsis is a major cause of mortality worldwide and is the third-leading cause of death in the United States. Sepsis is resource-intensive and requires prompt recognition and treatment to reduce mortality. The impact of sepsis is not only on in-hospital survival but extends into post-discharge quality of life and risk of re-admission. As the understanding of sepsis physiology evolved, so have the recommended screening tools and treatment protocol which challenge prior standards of care. There have been noteworthy efforts by the Surviving Sepsis Campaign, the Third International Consensus Definitions for Sepsis and the Centers for Medicare and Medicaid Services to establish core measure bundles. This review highlights both the 2021 SSC International Guidelines and the 2015 CMS Severe Sepsis/Septic Shock Core Measure Bundle, or SEP-1. Notably, the SEP-1 bundle was implemented as a value-based purchasing program, linking care of sepsis patients to financial incentives. The objective is to explore the most current evidence-based data to inform clinical practice while utilizing the available guidelines as a roadmap.
脓毒症是全球范围内主要的死亡原因之一,也是美国的第三大死亡原因。脓毒症需要耗费大量资源,并且需要及时识别和治疗,以降低死亡率。脓毒症的影响不仅在于住院期间的生存,还延伸到出院后的生活质量和再次入院的风险。随着对脓毒症生理学的认识不断发展,推荐的筛查工具和治疗方案也在不断发展,这对先前的护理标准提出了挑战。拯救脓毒症运动、第三届国际脓毒症和脓毒性休克定义共识会议以及医疗保险和医疗补助服务中心都在努力制定核心措施包。这篇综述重点介绍了 2021 年 SSC 国际指南和 2015 年 CMS 严重脓毒症/脓毒性休克核心措施包,或 SEP-1。值得注意的是,SEP-1 捆绑包是作为一项基于价值的购买计划实施的,将脓毒症患者的护理与经济激励措施联系起来。其目的是探索最新的循证数据,为临床实践提供信息,并利用现有的指南作为路线图。