Does Being Transported by Emergency Medical Services Improve Compliance with the Surviving Sepsis Bundle and Mortality Rate? A Retrospective Cohort Study

Faisal Alhusain; Hanin Alsuwailem; Alanoud Aldrees; Ahad Bugis; Sarah Alzuhairi; Sami Alsulami; Yaseen Arabi; Nawfal Aljerian

doi:10.2991/jegh.k.191215.001

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Volume 10, Issue 4, December 2020, Pages 276 - 279

Does Being Transported by Emergency Medical Services Improve Compliance with the Surviving Sepsis Bundle and Mortality Rate? A Retrospective Cohort Study

Authors

Faisal Alhusain¹^{, 2}^{, *}, Hanin Alsuwailem³, Alanoud Aldrees¹^{, 2}, Ahad Bugis³, Sarah Alzuhairi³, Sami Alsulami²^{, 4}, Yaseen Arabi²^{, 5}, Nawfal Aljerian²^{, 4}

¹College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

²King Abdullah International Medical Research Center, Riyadh, Saudi Arabia

³College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia

⁴Emergency Medicine Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia

⁵Intensive Care Unit Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia

^*Corresponding author. Department of Emergency Medicine, Ministry of the National Guard – Health Affairs, Riyadh, Saudi Arabia. Email: Faisalaalhusain@gmail.com

Corresponding Author

Faisal Alhusain

Received 23 August 2019, Accepted 11 December 2019, Available Online 31 December 2019.

DOI: 10.2991/jegh.k.191215.001 How to use a DOI?
Keywords: Acute care; basic ambulance care; emergency department; prehospital care; clinical management; critical care transport
Abstract: Background: This study aimed to investigate the relationship between patients with severe sepsis or septic shock being transported to the Emergency Department (ED) by Emergency Medical Services (EMS) and the compliance with the 3-h sepsis resuscitation bundle [Surviving Sepsis Campaign (SSC)], and to compare the management and laboratory results of patients transported by EMS or non-EMS transport.

Methods: A retrospective cohort study was conducted using data from a quality-improvement project at King Abdulaziz Medical City in Riyadh. The data for patients who presented to ED with sepsis (severe sepsis or septic shock) was categorized as being transported with EMS or non-EMS. The two groups were compared in terms of compliance with the SSC bundle and 30-day mortality.

Results: In a sample of 436 patients with severe sepsis or septic shock presented at the ED during the study period, EMS transported almost one-third of the patients (134, 31%) and 302 patients (69%) used non-EMS transport. For the EMS group, adherence to intravenous fluid was 91.4% compared with 87% for the non-EMS group (p = 0.19), antibiotics (EMS 50.7% vs non-EMS 52%, p = 0.81), blood cultures before antibiotics (EMS 53% vs non-EMS 47.4%, p = 0.21), and measuring lactate levels (EMS 73.1% vs non-EMS 57%, p = <0.01). The mortality rate was 48.5% for the EMS group and 54% for the non-EMS group, which was not statistically significant.

Conclusion: Whether transported with or without EMS did not result in a statistically significant difference in patients presenting with sepsis, in terms of the adherence to the SSC bundle elements or the 30-day hospital mortality rate. The only statistically significant difference was the time to lactate measurement.
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

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Journal: Journal of Epidemiology and Global Health
Volume-Issue: 10 - 4
Pages: 276 - 279
Publication Date: 2019/12/31
ISSN (Online): 2210-6014
ISSN (Print): 2210-6006
DOI: 10.2991/jegh.k.191215.001 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).

Cite this article

ris enw bib

TY  - JOUR
AU  - Faisal Alhusain
AU  - Hanin Alsuwailem
AU  - Alanoud Aldrees
AU  - Ahad Bugis
AU  - Sarah Alzuhairi
AU  - Sami Alsulami
AU  - Yaseen Arabi
AU  - Nawfal Aljerian
PY  - 2019
DA  - 2019/12/31
TI  - Does Being Transported by Emergency Medical Services Improve Compliance with the Surviving Sepsis Bundle and Mortality Rate? A Retrospective Cohort Study
JO  - Journal of Epidemiology and Global Health
SP  - 276
EP  - 279
VL  - 10
IS  - 4
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.191215.001
DO  - 10.2991/jegh.k.191215.001
ID  - Alhusain2019
ER  -

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