Health administration faculty collaborated with emergency medicine faculty and staff on a quality-improvement article regarding severe sepsis treatment that was published in the April 2007 issue of Critical Care Medicine.
The article, “Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality,” documents a two-year effort to ensure that five specific treatments—“the bundle”—are provided to severe sepsis patients within six hours of presentation in the emergency department. The provision of such a bundle is associated with an absolute 19 percent reduction in mortality.
Lead author H. Bryant Nguyen, MD, emergency medicine critical care director at LLUMC, was especially pleased by an accompanying editorial that positively reviewed his work and commented on the difficulty of implementing new practices in real-life settings.
Dr. Nguyen has collaborated with Jim Banta, PhD, MPH, of the School of Public Health on a follow-up study, “Evaluation of APACHE II, SAPS II, MEDS and MPM II0 for the prognostication of severe sepsis or septic shock patients presenting to the emergency department,” which was presented in February at the Society of Critical Care Medicine Annual Congress, in Orlando, Florida.
The two have also received a School of Public Health seed grant to examine the impact of hospital characteristics on mortality and costs of sepsis patients in a nationwide sample of hospitals.
Severe sepsis (infection-induced organ failure) is associated with a 20 percent to 50 percent mortality rate among patients and is the 10th leading cause of death in the United States, resulting in an annual economic burden of nearly $17 billion.
Among the 751,000 annual cases of severe sepsis in the United States, approximately 458,200 cases (or 61 percent) are first encountered in the emergency department.