[Impact of bundle therapy for sepsis on patient prognosis and its current implementation status].

Abstract

Objective: To investigate the correlation between the completion rate of sepsis 1-hour bundle therapy and the prognosis of patients with sepsis or septic shock, as well as to survey the awareness and implementation status of sepsis bundle therapy among medical staff in intensive care unit (ICU). Methods: The medical records of patients with sepsis or septic shock admitted to the Department of Critical Care Medicine of Zhongda Hospital, Southeast University from January 2020 to January 2024 were analyzed retrospectively. The patients were divided into two groups based on whether the bundle therapy was completed. The correlation between the completion of sepsis bundle therapy and the 28-day mortality rate of patients was analyzed. From August 3 to 20, 2023, a survey on the awareness and implementation status of sepsis bundle therapy among ICU medical staff in China was conducted using the WJX (Questionnaire Star) form. Results: A total of 712 patients with sepsis or septic shock were included in the analysis, comprising 470 males and 242 females, with a mean age of (66.92±16.36) years. Among them, 575 (80.8%) were in the bundle therapy completion group, and 137 (19.2%) were in the non-completion group. There were no statistically significant differences in age, gender, and disease severity between the two groups (P>0.05). However, the 28-day mortality rate was lower in the completion group compared to that in the non-completion group (28.7% vs 39.4%, P=0.015). Completion of bundle therapy was associated with a lower mortality risk in patients with sepsis or septic shock (OR=0.358, 95%CI: 0.216-0.595). The survey part included 1 339 ICU medical staff from 680 hospitals across 32 provinces, autonomous regions, and municipalities in China, with a valid response rate of 99.0% (1 325/1 339). Among them, 92.5% (1 226/1 325) of the ICU medical staff claimed to have mastered the diagnostic criteria and treatment measures of sepsis bundle therapy, but in reality, only 25.2% (334/1, 325) of the ICU medical staff could fully grasp the relevant knowledge. The surveyed ICU medical staff focused their suggestions for improving the completion rate of sepsis bundle therapy on knowledge training (86.6%, 1 148/1 325), quality supervision and feedback (79.8%, 1 057/1 325), and improvement of information-based data capture (72.2%, 957/1 325). Conclusions: The completion rate of sepsis bundle therapy is correlated with the 28-day mortality rate of patients with sepsis or septic shock. The mastery of sepsis bundle therapy by ICU medical staff is not satisfactory.