The Effect of Early Goal-directed Therapy Protocol Implementation on the Prognosis of Patients with Severe Sepsis and Septic Shock in the Emergency Department

ABSTRACT

PURPOSE: Early goal-directed therapy (EGDT) has been known to reduce the mortality of patients with severe sepsis and septic shock. We wanted to determine the clinical effectiveness of implementing EGDT as a protocol in the emergency department (ED). METHODS: A prospective, non-blinded, interventional study was conducted for 14 months at a university hospital ED (EGDT group). And a medical records of patients who were treated with the same diagnosis were reviewed retrospectively during same durations 4 years ago (non-EGDT group). Data were collected for age, sex, simplified acute physiology score (SAPS) III, sources of infection, length of stay (LOS) in the intensive care unit (ICU) and in the hospital, and 1- and 28-day mortality. RESULTS: 59 patients were enrolled in the non-EGDT group and 41 in the EGDT group. Age, sex, SAPS III, ICU LOS, hospital LOS, and 1- and 28-day mortality were not significantly different between the groups. CONCLUSION: In our study, implementation of an EGDT protocol in ED couldn't improve the prognosis of patients with severe sepsis and septic shock.