Please use this identifier to cite or link to this item: https://doi.org/10.1136/bmj.d3245
Title: Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study
Authors: Phua, Jason 
Koh, Younsuck
Du, Bin
Tang, Yao-Qing
Divatia, Jigeeshu V
Tan, Cheng Cheng
Gomersall, Charles D
Faruq, Mohammad Omar
Shrestha, Babu Raja
Nguyen, Gia Binh
Arabi, Yaseen M
Salahuddin, Nawal
Wahyuprajitno, Bambang
Tu, Mei-Lien
Abd Wahab, Ahmad Yazid Haji
Hameed, Akmal A
Nishimura, Masaji
Procyshyn, Mark
Chan, Yiong Huak 
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
SURVIVING SEPSIS
SEPTIC SHOCK
PRACTICE GUIDELINES
CAMPAIGN
MORTALITY
THERAPY
HYDROCORTISONE
DEFINITIONS
MEDICINE
OUTCOMES
Issue Date: 13-Jun-2011
Publisher: BMJ PUBLISHING GROUP
Citation: Phua, Jason, Koh, Younsuck, Du, Bin, Tang, Yao-Qing, Divatia, Jigeeshu V, Tan, Cheng Cheng, Gomersall, Charles D, Faruq, Mohammad Omar, Shrestha, Babu Raja, Nguyen, Gia Binh, Arabi, Yaseen M, Salahuddin, Nawal, Wahyuprajitno, Bambang, Tu, Mei-Lien, Abd Wahab, Ahmad Yazid Haji, Hameed, Akmal A, Nishimura, Masaji, Procyshyn, Mark, Chan, Yiong Huak (2011-06-13). Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study. BMJ-BRITISH MEDICAL JOURNAL 342 (7812). ScholarBank@NUS Repository. https://doi.org/10.1136/bmj.d3245
Abstract: Objectives: To assess the compliance of Asian intensive care units and hospitals to the Surviving Sepsis Campaign's resuscitation and management bundles. Secondary objectives were to evaluate the impact of compliance on mortality and the organisational characteristics of hospitals that were associated with higher compliance. Design: Prospective cohort study. Setting: 150 intensive care units in 16 Asian countries. Participants: 1285 adult patients with severe sepsis admitted to these intensive care units in July 2009. The organisational characteristics of participating centres, the patients' baseline characteristics, the achievement of targets within the resuscitation and management bundles, and outcome data were recorded. Main outcome measure: Compliance with the Surviving Sepsis Campaign's resuscitation (six hours) and management (24 hours) bundles. Results: Hospital mortality was 44.5% (572/1285). Compliance rates for the resuscitation and management bundles were 7.6% (98/1285) and 3.5% (45/1285), respectively. On logistic regression analysis, compliance with the following bundle targets independently predicted decreased mortality: blood cultures (achieved in 803/1285; 62.5%, 95% confidence interval 59.8% to 65.1%), broad spectrum antibiotics (achieved in 821/ 1285; 63.9%, 61.3% to 66.5%), and central venous pressure (achieved in 345/870; 39.7%, 36.4% to 42.9%). High income countries, university hospitals, intensive care units with an accredited fellowship programme, and surgical intensive care units were more likely to be compliant with the resuscitation bundle. Conclusions: While mortality from severe sepsis is high, compliance with resuscitation and management bundles is generally poor in much of Asia. As the centres included in this study might not be fully representative, achievement rates reported might overestimate the true degree of compliance with recommended care and should be interpreted with caution. Achievement of targets for blood cultures, antibiotics, and central venous pressure was independently associated with improved survival.
Source Title: BMJ-BRITISH MEDICAL JOURNAL
URI: https://scholarbank.nus.edu.sg/handle/10635/209045
ISSN: 17561833
DOI: 10.1136/bmj.d3245
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