Clin Exp Emerg Med.  2017 Sep;4(3):146-153. 10.15441/ceem.17.204.

Korean Shock Society septic shock registry: a preliminary report

Affiliations
  • 1Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 2Department of Emergency Medicine, Hallym University College of Medicine, Seoul, Korea.
  • 3Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 4Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 5Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
  • 6Department of Emergency Medicine, Guro Hospital, Korea University Medical Center, Seoul, Korea.
  • 7Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. suhgil@snu.ac.kr
  • 8Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea.
  • 9Department of Emergency Medicine, Korea University Anam Hospital, Seoul, Korea.
  • 10Department of Emergency Medicine, Kyung Hee University Hospital, Seoul, Korea.

Abstract


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.

Keyword

Sepsis; Septic shock; Mortality; Patient care bundles

MeSH Terms

Central Venous Pressure
Compliance
Emergency Service, Hospital
Humans
Hyperlactatemia
Hypotension
Lactic Acid
Male
Mortality
Oxygen
Patient Care Bundles
Prospective Studies
Resuscitation
Sepsis
Shock*
Shock, Septic*
Lactic Acid
Oxygen
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