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KMID : 1100620170040030146
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Clinical and Experimental Emergency Medicine
2017 Volume.4 No. 3 p.146 ~ p.153
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Korean Shock Society septic shock registry: a preliminary report
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Shin Tae-Gun
Hwang Sung-Yeon
Kang Gu-Hyun
Kim Won-Young
Ryoo Seung-Mok
Kim Kyu-Seok
Jo You-Hwan
Chung Sung-Phil
Joo Young-seon
Choi Sung-Hyuk
Yoon Young-Hoon
Kwon Woon-Yong
Lim Tae-Ho
Han Kap-Su
Choi Han-Sung
Suh Gil-Joon
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Abstract
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Objective: To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED).
Methods: This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included.
Results: A total of 468 patients were enrolled (median age, 71.3 years; male, 55.1%; refractory hypotension, 82.9%; hyperlactatemia without hypotension, 17.1%). Respiratory infection was the most common source of infection (31.0%). The median Sepsis-related Organ Failure Assessment score was 7.5. The sepsis bundle compliance was 91.2% for lactate measurement, 70.3% for blood culture, 68.4% for antibiotic administration, 80.3% for fluid resuscitation, 97.8% for vasopressor application, 68.0% for central venous pressure measurement, 22.0% for central venous oxygen saturation measurement, and 59.2% for repeated lactate measurement. Among patients who underwent interventions for source control (n=117, 25.1%), 43 (36.8%) received interventions within 12 hours of ED arrival. The in-hospital, 28-day, and 90-day mortality rates were 22.9%, 21.8%, and 27.1%, respectively. The median ED and hospital lengths of stay were 6.8 hours and 12 days, respectively.
Conclusion: This preliminary report revealed a mortality of over 20% in patients with septic shock, which suggests that there are areas for improvement in terms of the quality of initial resuscitation and outcomes of septic shock patients in the ED.
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KEYWORD
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Sepsis, Septic shock, Mortality, Patient care bundles
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