286 - Evaluation of an Emergency Department Code Sepsis Initiative
Thursday, May 14, 2020
2:12 PM – 2:20 PM
Location: Savoy: Majestic Level
Participants should be aware of the following financial/non-financial relationships:
Antony Mathew, MD: No financial relationships or conflicts of interest
Alexandra Barshied: No disclosure data submitted.
Tamar Motov: No disclosure data submitted.
Zachary Lockerman: No disclosure data submitted.
Corey Weiner, MD: No disclosure data submitted.
Antonios Likourezos, MA, MPH: No disclosure data submitted.
John Marshall: No disclosure data submitted.
Eitan Dickman, MD: No disclosure data submitted.
Jefferson Drapkin, MPH: No disclosure data submitted.
Background and Objectives: Early aggressive intervention in septic patients has been previously demonstrated to have a positive impact on patient outcomes. In March 2017, a “Code Sepsis” program was initiated in the Maimonides ED to alert staff regarding the critical nature of the patient’s condition, improve communication between nursing, physician, and pharmacy staff engaged in caring for the patient, and to ensure that a plan was in place for the successful completion of the government mandated 3 and 6-hour bundles. The objective of this study was to determine whether activating a Code Sepsis in the ED improved outcomes of patients with severe sepsis and septic shock.
Methods: We conducted a chart review of septic patients from March 2017 to June 2019 who had a lactate > 4mmol/liter. We compared those patients for whom a Code Sepsis was initiated (group 1) vs those in which it was not (group 2) in regards to mortality rate, bundle compliance, vasopressor use, and hospital length of stay (LOS).
Results: A total of 680 patients (274 in group 1 and 406 in group 2) met inclusion criteria. The demographic characteristics were similar in both groups; 53% male, mean 75 years old (P>.05). In both groups, approximately 27% required vasopressors (P=.719). 29% of group 1 vs. 35% of group 2 expired in the hospital (P=.139). The hospital LOS was 2 days longer for group 2; 9.2 days for group 1 and 11.1 days for group 2 (P=.314). Compliance with 3 and 6 hour bundle requirements in group 1 and 2 were (76% vs, 70%; P=.076) and (51% vs. 37%; P<.0001), respectively.
Conclusion: Patients in the Code Sepsis group had greater compliance with the 6 hour bundle. Mortality rates and LOS were also improved, although these did not reach statistical significance.