Effect of simple-bundles management vs. guideline-bundles management on elderly patients with septic shock: a retrospective study

Link to article at PubMed

Ann Palliat Med. 2021 May 10:apm-20-2320. doi: 10.21037/apm-20-2320. Online ahead of print.

ABSTRACT

BACKGROUND: The objective of this study was to compare the effects of simple-bundles management and guideline-bundles management on elderly patients with severe sepsis and septic shock.

METHODS: This was a single-center retrospective observational study of elderly patients with a hospital discharge diagnosis of severe sepsis or septic shock from First Hospital of Tsinghua University from January 2014 to December 2018. Management for patients from emergency ward adhered to the simple bundles. Management for patients from intensive care unit adhered to Surviving Sepsis Campaign Guidelines 2012. Data of the two groups were collected to determine the demographic, the source of infection, the baseline physiology, the Acute Physiology and Chronic Health Evaluation (APACHE) II Scores and the serum lactate concentration during the in-hospital period and were compared. The 30-, 60-, and 90-day mortality were compared between the two groups.

RESULTS: One hundred patients came from emergency ward and ninety-eight patients came from intensive care unit met the inclusion criteria. There were no significant differences between the two groups in demographic and clinical characteristics at baseline (P>0.05). There were no significant differences between the two groups in the APACHE-II scores and the lactate concentration at 6, 24, 72 hours after management and before management (P>0.05). There were also no significant differences between the two groups in the 30-, 60- and 90-day mortality (P>0.05).

CONCLUSIONS: The level of improvement achieved in the simple-bundles group was similar with that achieved in the guideline-bundles group. Guideline-bundles management, compared with simple-bundles management, might not decrease mortality among elderly patients with severe sepsis and septic shock.

PMID:33977740 | DOI:10.21037/apm-20-2320

Leave a Reply

Your email address will not be published. Required fields are marked *