{"title":"在脓毒症的初始治疗中,遵守《日本脓毒症和脓毒性休克管理临床实践指南2024》的全国性调查。","authors":"Takehiko Oami, Daisuke Kasugai, Kazuma Yamakawa, Tadashi Matsuoka, Kenichi Kano, Yoshitaka Aoki, Tomoaki Yatabe, Nobuaki Shime, Taka-Aki Nakada","doi":"10.1186/s40560-025-00819-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Japanese Clinical Practice Guidelines for the Management of Sepsis and Septic Shock 2024 (J-SSCG2024) were developed to improve the standardization and quality of sepsis care across various clinical settings. However, real-world adherence to these recommendations among healthcare professionals in Japan remains unclear. The objective of this study was to assess patterns of adherence to the J-SSCG2024 and identify factors associated with variation in clinical practice.</p><p><strong>Methods: </strong>We conducted a nationwide web-based cross-sectional survey targeting healthcare professionals, administering a questionnaire that included 23 items reflecting the key J-SSCG2024 recommendations for the initial management of sepsis, along with demographic and professional background information. Cluster analysis was performed to identify the distinct adherence patterns. Subgroup analyses were conducted to explore the association between respondent characteristics and guideline compliance. Additionally, sensitivity analyses were performed to evaluate the robustness of the findings across distinct cluster numbers.</p><p><strong>Results: </strong>A total of 734 healthcare professionals participated in the survey, most of whom were physicians (92.4%) with over 20 years of clinical experience (54.0%). High adherence was observed for recommendations, such as blood purification and the use of first-line vasopressors. However, substantial variation was detected in practices related to adjuvant therapies and initial resuscitation, particularly regarding the timing of vasopressor initiation and the use of beta-blockers. Cluster analysis revealed four distinct adherence profiles. Higher adherence was associated with expertise in emergency and critical care medicine, affiliation with intensive care units or emergency departments, and a higher number of patients with sepsis managed monthly. These findings were consistent across the sensitivity analyses.</p><p><strong>Conclusions: </strong>This nationwide survey identified characteristic clusters based on adherence to the J-SSCG2024 among Japanese clinicians. Targeted implementation strategies are essential to enhance guideline adoption, particularly among clinicians outside specialized critical care settings.</p>","PeriodicalId":16123,"journal":{"name":"Journal of Intensive Care","volume":"13 1","pages":"51"},"PeriodicalIF":4.7000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482439/pdf/","citationCount":"0","resultStr":"{\"title\":\"Nationwide survey of adherence to the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024 in the initial management of sepsis.\",\"authors\":\"Takehiko Oami, Daisuke Kasugai, Kazuma Yamakawa, Tadashi Matsuoka, Kenichi Kano, Yoshitaka Aoki, Tomoaki Yatabe, Nobuaki Shime, Taka-Aki Nakada\",\"doi\":\"10.1186/s40560-025-00819-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The Japanese Clinical Practice Guidelines for the Management of Sepsis and Septic Shock 2024 (J-SSCG2024) were developed to improve the standardization and quality of sepsis care across various clinical settings. However, real-world adherence to these recommendations among healthcare professionals in Japan remains unclear. The objective of this study was to assess patterns of adherence to the J-SSCG2024 and identify factors associated with variation in clinical practice.</p><p><strong>Methods: </strong>We conducted a nationwide web-based cross-sectional survey targeting healthcare professionals, administering a questionnaire that included 23 items reflecting the key J-SSCG2024 recommendations for the initial management of sepsis, along with demographic and professional background information. Cluster analysis was performed to identify the distinct adherence patterns. Subgroup analyses were conducted to explore the association between respondent characteristics and guideline compliance. Additionally, sensitivity analyses were performed to evaluate the robustness of the findings across distinct cluster numbers.</p><p><strong>Results: </strong>A total of 734 healthcare professionals participated in the survey, most of whom were physicians (92.4%) with over 20 years of clinical experience (54.0%). High adherence was observed for recommendations, such as blood purification and the use of first-line vasopressors. However, substantial variation was detected in practices related to adjuvant therapies and initial resuscitation, particularly regarding the timing of vasopressor initiation and the use of beta-blockers. Cluster analysis revealed four distinct adherence profiles. Higher adherence was associated with expertise in emergency and critical care medicine, affiliation with intensive care units or emergency departments, and a higher number of patients with sepsis managed monthly. These findings were consistent across the sensitivity analyses.</p><p><strong>Conclusions: </strong>This nationwide survey identified characteristic clusters based on adherence to the J-SSCG2024 among Japanese clinicians. Targeted implementation strategies are essential to enhance guideline adoption, particularly among clinicians outside specialized critical care settings.</p>\",\"PeriodicalId\":16123,\"journal\":{\"name\":\"Journal of Intensive Care\",\"volume\":\"13 1\",\"pages\":\"51\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12482439/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Intensive Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s40560-025-00819-6\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Intensive Care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s40560-025-00819-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Nationwide survey of adherence to the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024 in the initial management of sepsis.
Background: The Japanese Clinical Practice Guidelines for the Management of Sepsis and Septic Shock 2024 (J-SSCG2024) were developed to improve the standardization and quality of sepsis care across various clinical settings. However, real-world adherence to these recommendations among healthcare professionals in Japan remains unclear. The objective of this study was to assess patterns of adherence to the J-SSCG2024 and identify factors associated with variation in clinical practice.
Methods: We conducted a nationwide web-based cross-sectional survey targeting healthcare professionals, administering a questionnaire that included 23 items reflecting the key J-SSCG2024 recommendations for the initial management of sepsis, along with demographic and professional background information. Cluster analysis was performed to identify the distinct adherence patterns. Subgroup analyses were conducted to explore the association between respondent characteristics and guideline compliance. Additionally, sensitivity analyses were performed to evaluate the robustness of the findings across distinct cluster numbers.
Results: A total of 734 healthcare professionals participated in the survey, most of whom were physicians (92.4%) with over 20 years of clinical experience (54.0%). High adherence was observed for recommendations, such as blood purification and the use of first-line vasopressors. However, substantial variation was detected in practices related to adjuvant therapies and initial resuscitation, particularly regarding the timing of vasopressor initiation and the use of beta-blockers. Cluster analysis revealed four distinct adherence profiles. Higher adherence was associated with expertise in emergency and critical care medicine, affiliation with intensive care units or emergency departments, and a higher number of patients with sepsis managed monthly. These findings were consistent across the sensitivity analyses.
Conclusions: This nationwide survey identified characteristic clusters based on adherence to the J-SSCG2024 among Japanese clinicians. Targeted implementation strategies are essential to enhance guideline adoption, particularly among clinicians outside specialized critical care settings.
期刊介绍:
"Journal of Intensive Care" is an open access journal dedicated to the comprehensive coverage of intensive care medicine, providing a platform for the latest research and clinical insights in this critical field. The journal covers a wide range of topics, including intensive and critical care, trauma and surgical intensive care, pediatric intensive care, acute and emergency medicine, perioperative medicine, resuscitation, infection control, and organ dysfunction.
Recognizing the importance of cultural diversity in healthcare practices, "Journal of Intensive Care" also encourages submissions that explore and discuss the cultural aspects of intensive care, aiming to promote a more inclusive and culturally sensitive approach to patient care. By fostering a global exchange of knowledge and expertise, the journal contributes to the continuous improvement of intensive care practices worldwide.