Outcomes of Thungsong sepsis treatment protocol in sepsis management, Thungsong Hospital Nakornsrithammarath Province

Abstract

Introduction: Sepsis is condition with high mortality rate and current public health problem. The treatment process includes administration of fluids, rapid and empirical antibiotics, proper administration of inotropic drugs and eliminates the source infection.

Objective: To compare mortality rates and results of the treatment process before and after using the treatment guideline.

Methods: A quasi-experimental retrospective study. Collect all patient data from inpatient medical records who diagnosed sepsis and septic shock, pretreatment group from Jan 1 to June 3 2022 and post treatment group between July 1 and Dec 31 2022

Results: This study enrolled 169 patients before guideline implementation and 277 patients after the guideline. The outcomes showed an increase in ICU admission that went from 12.4% to 23.8% (P=0.04). Doctors that used the guidelines increased from 53.3% to 63.3% (P=0.01) and assessed early warning signs that rosed from 42.6 to 52.8% (P=0.02). By using the guideline, the duration of blood draw process for culture and initial antibiotics were increased from 30 minutes to 20 minutes (P<0.001). Treatment by the administering was more than 30cc/kg/hour of fluid in patients with low blood pressure (septic shock). It was found that after using the guidelines, fluid administration increased from 55.1% to 71.7% (P=0.042). The result of mortality rate after deducting palliative care decreased from 11.8% to 9%(P=0.339)  

Conclusion: The results of the treatment process after using the guidelines were found that the treatment process improved. Meanwhile the results of mortality rate were not signifincantly decreased.