Time to decision in sepsis.
Rev Esp Quimioter
; 36(1): 82-87, 2023 Feb.
Article
in En
| MEDLINE
| ID: mdl-36331185
ABSTRACT
OBJECTIVE:
This study aimed to identify the common barriers leading to delayed initial management, microbiological diagnosis, and appropriate empirical antimicrobial treatment in sepsis.METHODS:
A cross-sectional study was performed by the application of a population-based survey. Four different surveys were designed, targeting the healthcare personnel located in main hospital areas [emergency department (SEMES); infectious diseases and clinical microbiology-microbiological diagnosis (SEIMC-M); intensive care and infectious diseases, (SEMICYUC-GTEIS); and infectious diseases and clinical microbiology-clinical diagnosis, (SEIMC-C)].RESULTS:
A total of 700 valid surveys were collected from June to November 2019 380 (54.3%) of SEMES, 127 (18.1%) of SEIMC-M, 97 (13.9%) de SEMICYUC-GTEIS and 96 (13.7%) of SEIMC-C, in 270 hospitals of all levels of care. The qSOFA score was used as a screening tool. The most used biomarker was procalcitonin (n=92, 39.8%). The sepsis code was implemented in 157 of 235 participating centers (66.2%), particularly in tertiary level hospitals. The mean frequency of contaminated blood cultures was 8.9% (8.7). In 85 (78.7%) centers, positive results of blood cultures were available within the first 72 hours and were communicated to the treating physician effectively by phone or e-mail in 76 (81.7%) cases. The main reason for escalating treatment was clinical deterioration, and the reason for de-escalating antimicrobials was significantly different between the specialties. Quality indicators were not frequently monitored among the different participating centers.CONCLUSIONS:
There are significant barriers that hinder adequate management processes in sepsis in Spanish hospitals.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Communicable Diseases
/
Sepsis
/
Anti-Infective Agents
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Rev Esp Quimioter
Journal subject:
TERAPIA POR MEDICAMENTOS
Year:
2023
Document type:
Article
Affiliation country:
España