Comparison of the treatment outcomes between Hour – 1 Bundle and usual care among septic shock patients at Emergency Room, Rajavithi hospital
Keywords:
Sepsis, Septic shock, Surviving sepsis campaign, Hour-1 bundle, MortalityAbstract
Background Sepsis and septic shock stand as a preeminent medical emergency, wherein prompt and accurate initial interventions within the critical early hours have demonstrated potential for enhancing patient outcomes. The Hour-1 Bundle has garnered endorsement within the recent iteration of the Surviving Sepsis Campaign. However, no statistical evidence regarding the mortality rate of patients when using Hour-1 Bundle for treating sepsis.
Objectives A comparative analysis of 28-day mortality among patients diagnosed with septic shock admitted to the emergency department of Rajavithi hospital: A study of the Hour-1 Bundle care versus usual care cohorts.
Methods A retrospective observational cohort study of septic patients from January to December 2018 for usual care, and from January to December 2022 for patients managed in accordance with the Hour-1 bundle protocol.
Results Enroll 300 patients who diagnosed sepsis shock categorized into two distinct groups: the Hour-1 bundle group (N=149) and the usual care group (N=151). The 28-day mortality is 97 out of 151 patients (64.23%) within the usual care group, and 70 out of 149 patients (46.62%) within the Hour-1 bundle group (P=0.003; OR 2.03; 95%CI 1.28 – 3.22). An expeditious resolution of shock within the initial hour of admission was notable in the Hour-1 bundle group with 119 out of 149 patients (79.86%) in contrast, the usual care group saw 25 out of 151 patients (16.56%) achieving such prompt resolution (P<0.001 ; OR 19.99 ; 95%CI 11.11 – 35.95).
Conclusion The implementation of the Hour-1 bundle protocol in septic shock patients demonstrated a discernible enhancement in the rates of 28-day mortality as well as success shock resuscitation within the initial hour.
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บทความที่ได้รับตีพิมพ์ในวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทย ถือเป็นเป็นลิขสิทธิ์ของ วิทยาลัยแพทย์เวชศาสตร์ฉุกเฉินแห่งประเทศไทย
กรณีที่บทความได้รับการตีพิมพ์ในวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทยแล้ว จะตีพิมพ์ในรูปแบบอิเล็กทรอนิกส์ ไม่มีสำเนาการพิมพ์ภายหลังหนังสือเผยแพร่เรียบร้อยแล้ว ผู้นิพนธ์ไม่สามารถนำบทความดังกล่าวไปนำเสนอหรือตีพิมพ์ในรูปแบบใดๆ ที่อื่นได้ หากมิได้รับคำอนุญาตจากวารสารเวชศาสตร์ฉุกเฉินแห่งประเทศไทย
