Table 3.
The sepsis care bundle, treatment, and outcome of study patients (n = 1018).
| Open ICU | Closed ICU | ||||
| n = 450 | n = 568 | P value | Missing | ||
| Sepsis care bundle | |||||
| Compliance with all applicable elements of sepsis 3-h resuscitation bundle | |||||
| Serum lactate obtained within 3-h of diagnosis of sepsis | no/total (%) | 426/449 (94.9) | 563/568 (99.1) | <0.001 | 1 |
| Broad-spectrum antibiotic given within 3-h of diagnosis of sepsis | no/total (%) | 357/448 (79.7) | 498/568 (87.7) | <0.001 | 2 |
| Blood cultures obtained before broad-spectrum antibiotic administration | no/total (%) | 388/447 (86.8) | 534/568 (94.0) | <0.001 | 3 |
| For hypotension or lactate concentration > 4 mmol/L, 30ml/kg crystalloid fluid bolus delivered within 3-h of diagnosis of sepsis | |||||
| Yes | no/total (%) | 192/444 (43.2) | 346/568 (60.9) | <0.001 | 6 |
| No | no/total (%) | 95/444 (21.4) | 88/568 (15.5) | ||
| Not indicated | no/total (%) | 157/444 (35.4) | 134/568 (23.6) | ||
| Entire 3-h bundle | no/total (%) | 246/449 (54.8) | 405/568 (71.3) | <0.001 | 1 |
| Compliance with all applicable elements of sepsis 6-h resuscitation bundle | |||||
| Vasopressors use followed initial fluid bolus if needed to maintain MAP ≧ 65 mmHg within 6-h of diagnosis of sepsis (yes/cases with indication) | |||||
| Yes | no/total (%) | 247/446 (55.4) | 391/568 (68.8) | <0.001 | 4 |
| No | no/total (%) | 35/446 (7.8) | 45/568 (7.9) | ||
| Not indicated | no/total (%) | 164/446 (36.8) | 132/568 (23.3) | ||
| Dopamine | no/total (%) | 43/247 (17.4) | 41/391 (10.5) | 0.01 | – |
| Dobutamine | no/total (%) | 18/247 (7.3) | 51/391 (13.0) | 0.02 | – |
| Noradrenaline | no/total (%) | 231/247 (93.5) | 374/391 (95.7) | 0.24 | – |
| For septic shock or lactate > 4 mmol/L, CVP measured within 6-h of diagnosis of sepsis (yes/cases with indication) | |||||
| Yes | no/total (%) | 64/446 (14.4) | 103/567 (18.2) | <0.001 | 5 |
| No | no/total (%) | 228/446 (51.1) | 330/567 (58.2) | ||
| Not indicated | no/total (%) | 154/446 (34.5) | 134/567 (23.6) | ||
| For septic shock or lactate > 4 mmol/L, ScvO2 measured within 6-h of diagnosis of sepsis (yes/cases with indication) | |||||
| Yes | no/total (%) | 24/446 (5.4) | 13/568 (2.3) | <0.001 | 4 |
| No | no/total (%) | 268/446 (60.1) | 420/568 (73.9) | ||
| Not indicated | no/total (%) | 154/446 (34.5) | 135/568 (23.8) | ||
| Re-measured lactate if initial lactate elevated | |||||
| Yes | no/total (%) | 309/446 (69.3) | 431/563 (76.6) | <0.001 | 9 |
| No | no/total (%) | 54/446 (12.1) | 21/563 (3.7) | ||
| Not indicated | no/total (%) | 83/446 (18.6) | 111/563 (19.7) | ||
| Entire 6-h bundle | no/total (%) | 16/358 (4.5) | 7/487 (1.4) | 0.007 | 173 |
| Vasopressors use and re-measured lactate in 6-h bundle | no/total (%) | 361/443 (81.5) | 500/563 (88.8) | 0.001 | 12 |
| Medications and interventions (from diagnosis to within 72 h after diagnosis) | |||||
| Time from diagnosis of sepsis to antibiotic use among patients who were given antibiotic within 3 h of diagnosis of sepsis | Median (IQR) | 80 (46–118) | 71 (34.0–118) | 0.15 | 5 |
| Noradrenaline | no/total (%) | 270/450 (60.0) | 403/567 (71.1) | <0.001 | 1 |
| Continuous renal replacement therapy | no/total (%) | 118/449 (26.3) | 159/565 (28.1) | 0.51 | 4 |
| Intermittent renal replacement therapy | no/total (%) | 14/447 (3.1) | 21/566 (3.7) | 0.62 | 5 |
| Polymyxin B Hemoperfusion | no/total (%) | 43/450 (9.6) | 41/567 (7.2) | 0.18 | 1 |
| Protease inhibitor (without sivelestat sodium) | no/total (%) | 66/446 (14.8) | 6/565 (1.1) | <0.001 | 7 |
| Sivelestat sodium | no/total (%) | 28/447 (6.3) | 8/566 (1.4) | <0.001 | 5 |
| Intravenous immunoglobulin | no/total (%) | 86/446 (19.3) | 117/564 (20.7) | 0.56 | 8 |
| Selective digestive decontamination | no/total (%) | 6/447 (1.3) | 3/564 (0.5) | 0.17 | 7 |
| Enteral nutrition | no/total (%) | 202/446 (45.3) | 276/565 (48.9) | 0.26 | 7 |
| Steroid | no/total (%) | 123/448 (27.5) | 196/564 (34.8) | 0.01 | 6 |
| Antithrombin | no/total (%) | 92/448 (20.5) | 125/566 (22.1) | 0.55 | 4 |
| Recombinant human soluble thrombomodulin | no/total (%) | 69/448 (15.4) | 144/564 (25.5) | <0.001 | 6 |
| Antibacterial and antifungal drug | |||||
| Sulbactam/Ampicillin | no/total (%) | 39/450 (8.7) | 25/568 (4.4) | 0.005 | – |
| Tazobactam/Piperacillin | no/total (%) | 101/450 (22.4) | 106/568 (18.7) | 0.14 | – |
| Ceftriaxone/Cefotaxime | no/total (%) | 43/450 (9.6) | 34/568 (6.0) | 0.03 | – |
| Carbapenem | no/total (%) | 199/450 (44.2) | 356/568 (62.7) | <0.001 | – |
| Vancomycin | no/total (%) | 63/450 (14.0) | 123/568 (21.7) | 0.002 | – |
| Anti MRSA drug except Vancomycin | no/total (%) | 15/450 (3.3) | 50/568 (8.8) | <0.001 | – |
| Antifungal drug | no/total (%) | 18/450 (4.0) | 28/568 (4.9) | 0.48 | – |
| ICU-free days | Median (IQR) | 19 (10–24) | 19 (10–24) | 0.48 | 204 |
| Ventilator-free days | Median (IQR) | 20 (0–28) | 21 (0–27) | 0.22 | 10 |
| Length of hospital stay | Median (IQR) | 23 (12–46) | 24 (12–45) | 0.82 | – |
| Hospital mortality | no/total (%) | 104/450 (23.1) | 142/568 (25.0) | 0.48 | – |