Journal of Epidemiology and Global Health

In Press, Corrected Proof, Available Online: 31 December 2019

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 Aldrees2, 4, Ahad Bugis3, Sarah Alzuhairi3, Sami Alsulami2, 4, 5, Yaseen Arabi2, 4, 5, Nawfal Aljerian1, 2, 4
1Department of Emergency Medicine, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia
2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
3College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia
4College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
5Intensive Care Unit Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
*Corresponding author. Email: Faisalaalhusain@gmail.com
Corresponding Author
Faisal Alhusain
Received 23 August 2019, Accepted 11 December 2019, Available Online 31 December 2019.
DOI
https://doi.org/10.2991/jegh.k.191215.001How 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.

Copyright
© 2019 Atlantis Press International B.V.
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
Publication Date
2019/12
ISSN (Online)
2210-6014
ISSN (Print)
2210-6006
DOI
https://doi.org/10.2991/jegh.k.191215.001How to use a DOI?
Copyright
© 2019 Atlantis Press International B.V.
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

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
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
SN  - 2210-6014
UR  - https://doi.org/10.2991/jegh.k.191215.001
DO  - https://doi.org/10.2991/jegh.k.191215.001
ID  - Alhusain2019
ER  -