Dataset Information

Association Between Time to Source Control in Sepsis and 90-Day Mortality.

ABSTRACT:

Importance

Rapid source control is recommended to improve patient outcomes in sepsis. Yet there are few data to guide how rapidly source control is required.

Objective

To determine the association between time to source control and patient outcomes in community-acquired sepsis.

Design, setting, and particpants

Multihospital integrated health care system cohort study of hospitalized adults (January 1, 2013, to December 31, 2017) with community-acquired sepsis as defined by Sepsis-3 who underwent source control procedures. Follow-up continued through January 1, 2019, and data analyses were completed March 17, 2022.

Exposures

Early (<6 hours) compared with late (6-36 hours) source control as well as each hour of source control delay (1-36 hours) from sepsis onset.

Main outcomes and measures

Multivariable models were clustered at the level of hospital with adjustment for patient factors, sepsis severity, resource availability, and the physiologic stress of procedures generating adjusted odds ratios (aOR) and 95% CI.

Results

Of 4962 patients with sepsis (mean [SD] age, 62 [16] years; 52% male; 85% White; mean [SD] Sequential Organ Failure Assessment score, 3.8 [2.5]), source control occurred at a median (IQR) of 15.4 hours (5.5-21.7) after sepsis onset, with 1315 patients (27%) undergoing source control within 6 hours. The crude 90-day mortality was similar for early and late source control (n = 177 [14%] vs n = 529 [15%]; P = .35). In multivariable models, early source control was associated with decreased risk-adjusted odds of 90-day mortality (aOR, 0.71; 95% CI, 0.63-0.80). This association was greater among gastrointestinal and abdominal (aOR, 0.56; 95% CI, 0.43-0.80) and soft tissue interventions (aOR, 0.72; 95% CI, 0.55-0.95) compared with orthopedic and cranial interventions (aOR, 1.33; 95% CI, 0.96-1.83; P < .001 for interaction).

Conclusions and relevance

Source control within 6 hours of community-acquired sepsis onset was associated with a reduced risk-adjusted odds of 90-day mortality. Prioritizing the rapid identification of septic foci and initiation of source control interventions can reduce the number of avoidable deaths among patients with sepsis.

SUBMITTER: Reitz KM

PROVIDER: S-EPMC9280613 | biostudies-literature | 2022 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Association Between Time to Source Control in Sepsis and 90-Day Mortality.

Reitz Katherine M KM Kennedy Jason J Li Shimena R SR Handzel Robert R Tonetti Daniel A DA Neal Matthew D MD Zuckerbraun Brian S BS Hall Daniel E DE Sperry Jason L JL Angus Derek C DC Tzeng Edith E Seymour Christopher W CW

JAMA surgery 20220901 9

<h4>Importance</h4>Rapid source control is recommended to improve patient outcomes in sepsis. Yet there are few data to guide how rapidly source control is required.<h4>Objective</h4>To determine the association between time to source control and patient outcomes in community-acquired sepsis.<h4>Design, setting, and particpants</h4>Multihospital integrated health care system cohort study of hospitalized adults (January 1, 2013, to December 31, 2017) with community-acquired sepsis as defined by S ...[more]

PMID: 35830181

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Dataset Information

Association Between Time to Source Control in Sepsis and 90-Day Mortality.

Importance

Objective

Design, setting, and particpants

Exposures

Main outcomes and measures

Results

Conclusions and relevance

Publications

Association Between Time to Source Control in Sepsis and 90-Day Mortality.

Similar Datasets

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