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Comparison of the treatment outcomes between Hour - 1 Bundle and usual care among septic shock patients at Emergency Room, Rajavithi hospital |
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| รหัสดีโอไอ | |
| Creator | Natchaya Treesaksrisakul. |
| Title | Comparison of the treatment outcomes between Hour - 1 Bundle and usual care among septic shock patients at Emergency Room, Rajavithi hospital |
| Publisher | P.A. LIVING.CO.,LTD. |
| Publication Year | 2566 |
| Journal Title | Thai Journal of Emergency Medicine. |
| Journal Vol. | 5 |
| Journal No. | 2 |
| Page no. | 42-58 |
| Keyword | Sepsis, Septic shock, Surviving sepsis campaign, Hour-1 bundle, Mortality. |
| URL Website | https://he02.tci-thaijo.org/index.php/TJEM/index |
| Website title | Thai jounal of Emergency Meddicine |
| ISSN | 2567-4924 |
| Abstract | Background Sepsis and septic shock stand as a preeminent medical emergency, wherein prompt and accurate initial interventions within the critical early hours have demonstrated potential for enhancing patient outcomes. The Hour-1 Bundle has garnered endorsement within the recent iteration of the Surviving Sepsis Campaign. However, no statistical evidence regarding the mortality rate of patients when using Hour-1 Bundle for treating sepsis. Objectives A comparative analysis of 28-day mortality among patients diagnosed with septic shock admitted to the emergency department of Rajavithi hospital: A study of the Hour-1 Bundle care versus usual care cohorts. Methods A retrospective observational cohort study of septic patients from January to December 2018 for usual care, and from January to December 2022 for patients managed in accordance with the Hour-1 bundle protocol. Results Enroll 300 patients who diagnosed sepsis shock categorized into two distinct groups: the Hour-1 bundle group (N=149) and the usual care group (N=151). The 28-day mortality is 97 out of 151 patients (64.23%) within the usual care group, and 70 out of 149 patients (46.62%) within the Hour-1 bundle group (P=0.003; OR 2.03; 95%CI 1.28 - 3.22). An expeditious resolution of shock within the initial hour of admission was notable in the Hour-1 bundle group with 119 out of 149 patients (79.86%) in contrast, the usual care group saw 25 out of 151 patients (16.56%) achieving such prompt resolution (P<0.001 ; OR 19.99;95%CI 11.11 - 35.95). Conclusion The implementation of the Hour-1 bundle protocol in septic shock patients demonstrated a discernible enhancement in the rates of 28-day mortality as well as success shock resuscitation within the initial hour. |
