Effect of early standardized treatment on clinical outcomes of patients with sepsis in primary hospitals / 中国中西医结合急救杂志

ABSTRACT

Objective To analyze the effect on clinical outcome of sepsis patients treated by early positive and standardized treatment in primary hospitals. Methods The clinical data of sepsis patients admitted to intensive care unit (ICU) of Dushanzi People's Hospital from January 1, 2015 to December 31, 2018 were retrospectively analyzed. The sepsis patients were further divided into a control group (from January to December, 2015) who received non-standardized treatment of sepsis, only according to doctors' experience, using routine antibiotics, fluid resuscitation, detection of lactic acid, etc. and a study group; from 2016, the patients with sepsis (the study group) received standardized diagnosis and treatment according to the Guidelines of Sepsis 3.0 and the actual conditions of our hospitals, and they were further subdivided into three periods 2016 (from January to December, 2016), 2017 (from January to December, 2017), and 2018 (from January to December, 2018) periods. The main clinical outcome indicator of these patients in 4 time periods, 28-day mortality, the secondary clinical outcome indicators such as the length of stay in ICU and medical expenses in ICU were observed. Results Sixty-six patients with sepsis were finally enrolled, including 17 cases in 2015, 18 cases in 2016, 17 cases in 2017 and 14 cases in 2018. Compared with 2015, the length of ICU stay in 2016, 2017 and 2018 were significantly shorter (days 17.45±9.09, 12.95±5.93, 12.14±4.92 vs. 20.85±13.45, all P <0.05), and the medical cost of ICU stay were significantly lower (ten thousand yuan 9.93±5.35, 7.22±3.86, 5.15±2.88 vs. 13.37±14.14, all P < 0.05); the 28-day mortality was significantly decreased [16.67% (3/18), 11.76% (2/17), and 14.29% (2/14) vs. 35.3% (6/17), all P < 0.05]. Conclusion Early standardized treatment for patients with sepsis can significantly reduce the length of stay in ICU and medical expenses in ICU.