Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)

Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medic...
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Autor*in:	Arjen M Dondorp [verfasserIn] Nicholas P J Day [verfasserIn] Suchart Booraphun [verfasserIn] Viriya Hantrakun [verfasserIn] Suwatthiya Siriboon [verfasserIn] Chaiyaporn Boonsri [verfasserIn] Pulyamon Poomthong [verfasserIn] Bung-Orn Singkaew [verfasserIn] Oratai Wasombat [verfasserIn] Parinya Chamnan [verfasserIn] Ratapum Champunot [verfasserIn] Kristina Rudd [verfasserIn] Prapit Teparrukkul [verfasserIn] Timothy Eoin West [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Übergeordnetes Werk:	In: BMJ Open - BMJ Publishing Group, 2011, 11(2021), 2
Übergeordnetes Werk:	volume:11 ; year:2021 ; number:2

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1136/bmjopen-2020-041022

Katalog-ID:	DOAJ052941515

Internformat


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520			\|a Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592.
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allfields	10.1136/bmjopen-2020-041022 doi (DE-627)DOAJ052941515 (DE-599)DOAJ8ad7ca8c6b304834ac035d7349ed0f98 DE-627 ger DE-627 rakwb eng Arjen M Dondorp verfasserin aut Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592. Medicine R Nicholas P J Day verfasserin aut Suchart Booraphun verfasserin aut Viriya Hantrakun verfasserin aut Suwatthiya Siriboon verfasserin aut Chaiyaporn Boonsri verfasserin aut Pulyamon Poomthong verfasserin aut Bung-Orn Singkaew verfasserin aut Oratai Wasombat verfasserin aut Parinya Chamnan verfasserin aut Ratapum Champunot verfasserin aut Kristina Rudd verfasserin aut Prapit Teparrukkul verfasserin aut Timothy Eoin West verfasserin aut In BMJ Open BMJ Publishing Group, 2011 11(2021), 2 (DE-627)654747075 (DE-600)2599832-8 20446055 nnns volume:11 year:2021 number:2 https://doi.org/10.1136/bmjopen-2020-041022 kostenfrei https://doaj.org/article/8ad7ca8c6b304834ac035d7349ed0f98 kostenfrei https://bmjopen.bmj.com/content/11/2/e041022.full kostenfrei https://doaj.org/toc/2044-6055 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2021 2
spelling	10.1136/bmjopen-2020-041022 doi (DE-627)DOAJ052941515 (DE-599)DOAJ8ad7ca8c6b304834ac035d7349ed0f98 DE-627 ger DE-627 rakwb eng Arjen M Dondorp verfasserin aut Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592. Medicine R Nicholas P J Day verfasserin aut Suchart Booraphun verfasserin aut Viriya Hantrakun verfasserin aut Suwatthiya Siriboon verfasserin aut Chaiyaporn Boonsri verfasserin aut Pulyamon Poomthong verfasserin aut Bung-Orn Singkaew verfasserin aut Oratai Wasombat verfasserin aut Parinya Chamnan verfasserin aut Ratapum Champunot verfasserin aut Kristina Rudd verfasserin aut Prapit Teparrukkul verfasserin aut Timothy Eoin West verfasserin aut In BMJ Open BMJ Publishing Group, 2011 11(2021), 2 (DE-627)654747075 (DE-600)2599832-8 20446055 nnns volume:11 year:2021 number:2 https://doi.org/10.1136/bmjopen-2020-041022 kostenfrei https://doaj.org/article/8ad7ca8c6b304834ac035d7349ed0f98 kostenfrei https://bmjopen.bmj.com/content/11/2/e041022.full kostenfrei https://doaj.org/toc/2044-6055 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2021 2
allfields_unstemmed	10.1136/bmjopen-2020-041022 doi (DE-627)DOAJ052941515 (DE-599)DOAJ8ad7ca8c6b304834ac035d7349ed0f98 DE-627 ger DE-627 rakwb eng Arjen M Dondorp verfasserin aut Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592. Medicine R Nicholas P J Day verfasserin aut Suchart Booraphun verfasserin aut Viriya Hantrakun verfasserin aut Suwatthiya Siriboon verfasserin aut Chaiyaporn Boonsri verfasserin aut Pulyamon Poomthong verfasserin aut Bung-Orn Singkaew verfasserin aut Oratai Wasombat verfasserin aut Parinya Chamnan verfasserin aut Ratapum Champunot verfasserin aut Kristina Rudd verfasserin aut Prapit Teparrukkul verfasserin aut Timothy Eoin West verfasserin aut In BMJ Open BMJ Publishing Group, 2011 11(2021), 2 (DE-627)654747075 (DE-600)2599832-8 20446055 nnns volume:11 year:2021 number:2 https://doi.org/10.1136/bmjopen-2020-041022 kostenfrei https://doaj.org/article/8ad7ca8c6b304834ac035d7349ed0f98 kostenfrei https://bmjopen.bmj.com/content/11/2/e041022.full kostenfrei https://doaj.org/toc/2044-6055 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2021 2
allfieldsGer	10.1136/bmjopen-2020-041022 doi (DE-627)DOAJ052941515 (DE-599)DOAJ8ad7ca8c6b304834ac035d7349ed0f98 DE-627 ger DE-627 rakwb eng Arjen M Dondorp verfasserin aut Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592. Medicine R Nicholas P J Day verfasserin aut Suchart Booraphun verfasserin aut Viriya Hantrakun verfasserin aut Suwatthiya Siriboon verfasserin aut Chaiyaporn Boonsri verfasserin aut Pulyamon Poomthong verfasserin aut Bung-Orn Singkaew verfasserin aut Oratai Wasombat verfasserin aut Parinya Chamnan verfasserin aut Ratapum Champunot verfasserin aut Kristina Rudd verfasserin aut Prapit Teparrukkul verfasserin aut Timothy Eoin West verfasserin aut In BMJ Open BMJ Publishing Group, 2011 11(2021), 2 (DE-627)654747075 (DE-600)2599832-8 20446055 nnns volume:11 year:2021 number:2 https://doi.org/10.1136/bmjopen-2020-041022 kostenfrei https://doaj.org/article/8ad7ca8c6b304834ac035d7349ed0f98 kostenfrei https://bmjopen.bmj.com/content/11/2/e041022.full kostenfrei https://doaj.org/toc/2044-6055 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2021 2
allfieldsSound	10.1136/bmjopen-2020-041022 doi (DE-627)DOAJ052941515 (DE-599)DOAJ8ad7ca8c6b304834ac035d7349ed0f98 DE-627 ger DE-627 rakwb eng Arjen M Dondorp verfasserin aut Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis) 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592. Medicine R Nicholas P J Day verfasserin aut Suchart Booraphun verfasserin aut Viriya Hantrakun verfasserin aut Suwatthiya Siriboon verfasserin aut Chaiyaporn Boonsri verfasserin aut Pulyamon Poomthong verfasserin aut Bung-Orn Singkaew verfasserin aut Oratai Wasombat verfasserin aut Parinya Chamnan verfasserin aut Ratapum Champunot verfasserin aut Kristina Rudd verfasserin aut Prapit Teparrukkul verfasserin aut Timothy Eoin West verfasserin aut In BMJ Open BMJ Publishing Group, 2011 11(2021), 2 (DE-627)654747075 (DE-600)2599832-8 20446055 nnns volume:11 year:2021 number:2 https://doi.org/10.1136/bmjopen-2020-041022 kostenfrei https://doaj.org/article/8ad7ca8c6b304834ac035d7349ed0f98 kostenfrei https://bmjopen.bmj.com/content/11/2/e041022.full kostenfrei https://doaj.org/toc/2044-6055 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_375 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 11 2021 2
language	English
source	In BMJ Open 11(2021), 2 volume:11 year:2021 number:2
sourceStr	In BMJ Open 11(2021), 2 volume:11 year:2021 number:2
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Medicine R
isfreeaccess_bool	true
container_title	BMJ Open
authorswithroles_txt_mv	Arjen M Dondorp @@aut@@ Nicholas P J Day @@aut@@ Suchart Booraphun @@aut@@ Viriya Hantrakun @@aut@@ Suwatthiya Siriboon @@aut@@ Chaiyaporn Boonsri @@aut@@ Pulyamon Poomthong @@aut@@ Bung-Orn Singkaew @@aut@@ Oratai Wasombat @@aut@@ Parinya Chamnan @@aut@@ Ratapum Champunot @@aut@@ Kristina Rudd @@aut@@ Prapit Teparrukkul @@aut@@ Timothy Eoin West @@aut@@
publishDateDaySort_date	2021-01-01T00:00:00Z
hierarchy_top_id	654747075
id	DOAJ052941515
language_de	englisch
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author	Arjen M Dondorp
spellingShingle	Arjen M Dondorp misc Medicine misc R Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
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topic_title	Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
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title	Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
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title_full	Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
author_sort	Arjen M Dondorp
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author_browse	Arjen M Dondorp Nicholas P J Day Suchart Booraphun Viriya Hantrakun Suwatthiya Siriboon Chaiyaporn Boonsri Pulyamon Poomthong Bung-Orn Singkaew Oratai Wasombat Parinya Chamnan Ratapum Champunot Kristina Rudd Prapit Teparrukkul Timothy Eoin West
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title_sort	effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (ubon-sepsis)
title_auth	Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
abstract	Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592.
abstractGer	Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592.
abstract_unstemmed	Objective To evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.Design A retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.Setting General medical wards and medical intensive care units (ICUs) of a study hospital.Participants Patients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposure The SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcome The primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.Results Of 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.Conclusions The SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration number NCT02217592.
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title_short	Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)
url	https://doi.org/10.1136/bmjopen-2020-041022 https://doaj.org/article/8ad7ca8c6b304834ac035d7349ed0f98 https://bmjopen.bmj.com/content/11/2/e041022.full https://doaj.org/toc/2044-6055
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author2	Nicholas P J Day Suchart Booraphun Viriya Hantrakun Suwatthiya Siriboon Chaiyaporn Boonsri Pulyamon Poomthong Bung-Orn Singkaew Oratai Wasombat Parinya Chamnan Ratapum Champunot Kristina Rudd Prapit Teparrukkul Timothy Eoin West
author2Str	Nicholas P J Day Suchart Booraphun Viriya Hantrakun Suwatthiya Siriboon Chaiyaporn Boonsri Pulyamon Poomthong Bung-Orn Singkaew Oratai Wasombat Parinya Chamnan Ratapum Champunot Kristina Rudd Prapit Teparrukkul Timothy Eoin West
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