Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol

Sepsis remains a leading cause of mortality in hospitalized patients. We evaluated characteristics and outcomes of patients identified through a comprehensive hospital-wide sepsis protocol over a 16-year period. This retrospective cohort study analyzed hospital-wide sepsis protocol activations at a...

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Autores: Giglio, Andres, Aranda Perez, Maria, Socias Mir, Antonia, del Castillo Blanco, Alberto, Mena, Joana, Franco, Sara, Ortega, Maria, Nieto Piñar, Yasmina, Estrada, Victor, de la Rica, Roberto, Borges, Marcio
Tipo de recurso: artículo
Fecha de publicación:2025
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/25935
Acceso en línea:https://hdl.handle.net/20.500.13003/25935
Access Level:acceso abierto
Palabra clave:Shock, Septic
Choque Séptico
early detection
hospital wide
mortality predictors
protocol activation
resource utilization
sepsis
septic shock
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spelling Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis ProtocolGiglio, AndresAranda Perez, MariaSocias Mir, Antoniadel Castillo Blanco, AlbertoMena, JoanaFranco, SaraOrtega, MariaNieto Piñar, YasminaEstrada, Victorde la Rica, RobertoBorges, MarcioShock, SepticShock, SepticChoque SépticoChoque Sépticoearly detectionhospital widemortality predictorsprotocol activationresource utilizationsepsisseptic shockSepsis remains a leading cause of mortality in hospitalized patients. We evaluated characteristics and outcomes of patients identified through a comprehensive hospital-wide sepsis protocol over a 16-year period. This retrospective cohort study analyzed hospital-wide sepsis protocol activations at a tertiary care hospital in Spain from 2006 to 2022. The protocol required at least two SIRS criteria plus evidence of organ dysfunction in patients over 14 years old. We analyzed demographics, activation criteria, hospital location, mortality predictors using univariate and multivariate analyses, including propensity score modeling, and resource utilization trends. A total of 10,919 patients with 14,546 protocol activations were identified. The median age was 69 years (IQR: 56-78), with 60.9% male patients. Protocol activations occurred in the emergency department (54%), ICU (34.2%), and inpatient wards (11.8%). The most common SIRS criteria were tachycardia (75.6%), tachypnea (50.4%), and fever (48.5%). Prevalent organ dysfunctions included hypotension (53%), hypoxemia (50.1%), oliguria (28.9%), and altered mental status (22%). Overall in-hospital mortality showed a significant linear downward trend from 26.5% in the first year to 13.6% in later years ( < 0.01). Propensity score analysis confirmed independent mortality predictors included hyperlactatemia (aOR 2.21), altered consciousness (aOR 2.09), hypotension (aOR 1.87), and leukopenia (aOR 1.79). ICU admission rate decreased from 58% to 24% over the study period. This 16-year analysis shows that comprehensive hospital-wide sepsis protocols achieve sustained mortality reduction with improved resource utilization efficiency. These findings support implementing comprehensive sepsis protocols as an effective strategy for improving sepsis outcomes.MDPI20252025-08-1420252025-08-14research articlehttp://purl.org/coar/resource_type/c_2df8fbb1info:eu-repo/semantics/articleapplication/pdfhttps://hdl.handle.net/20.500.13003/25935reponame:Docusalutinstname:Conselleria de Salut i Consum del Govern de les Illes BalearsInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:docusalut.com:20.500.13003/259352026-06-22T12:44:07Z
dc.title.none.fl_str_mv Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
title Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
spellingShingle Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
Giglio, Andres
Shock, Septic
Shock, Septic
Choque Séptico
Choque Séptico
early detection
hospital wide
mortality predictors
protocol activation
resource utilization
sepsis
septic shock
title_short Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
title_full Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
title_fullStr Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
title_full_unstemmed Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
title_sort Decoding Sepsis: A 16-Year Retrospective Analysis of Activation Patterns, Mortality Predictors, and Outcomes from a Hospital-Wide Sepsis Protocol
dc.creator.none.fl_str_mv Giglio, Andres
Aranda Perez, Maria
Socias Mir, Antonia
del Castillo Blanco, Alberto
Mena, Joana
Franco, Sara
Ortega, Maria
Nieto Piñar, Yasmina
Estrada, Victor
de la Rica, Roberto
Borges, Marcio
author Giglio, Andres
author_facet Giglio, Andres
Aranda Perez, Maria
Socias Mir, Antonia
del Castillo Blanco, Alberto
Mena, Joana
Franco, Sara
Ortega, Maria
Nieto Piñar, Yasmina
Estrada, Victor
de la Rica, Roberto
Borges, Marcio
author_role author
author2 Aranda Perez, Maria
Socias Mir, Antonia
del Castillo Blanco, Alberto
Mena, Joana
Franco, Sara
Ortega, Maria
Nieto Piñar, Yasmina
Estrada, Victor
de la Rica, Roberto
Borges, Marcio
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Shock, Septic
Shock, Septic
Choque Séptico
Choque Séptico
early detection
hospital wide
mortality predictors
protocol activation
resource utilization
sepsis
septic shock
topic Shock, Septic
Shock, Septic
Choque Séptico
Choque Séptico
early detection
hospital wide
mortality predictors
protocol activation
resource utilization
sepsis
septic shock
description Sepsis remains a leading cause of mortality in hospitalized patients. We evaluated characteristics and outcomes of patients identified through a comprehensive hospital-wide sepsis protocol over a 16-year period. This retrospective cohort study analyzed hospital-wide sepsis protocol activations at a tertiary care hospital in Spain from 2006 to 2022. The protocol required at least two SIRS criteria plus evidence of organ dysfunction in patients over 14 years old. We analyzed demographics, activation criteria, hospital location, mortality predictors using univariate and multivariate analyses, including propensity score modeling, and resource utilization trends. A total of 10,919 patients with 14,546 protocol activations were identified. The median age was 69 years (IQR: 56-78), with 60.9% male patients. Protocol activations occurred in the emergency department (54%), ICU (34.2%), and inpatient wards (11.8%). The most common SIRS criteria were tachycardia (75.6%), tachypnea (50.4%), and fever (48.5%). Prevalent organ dysfunctions included hypotension (53%), hypoxemia (50.1%), oliguria (28.9%), and altered mental status (22%). Overall in-hospital mortality showed a significant linear downward trend from 26.5% in the first year to 13.6% in later years ( < 0.01). Propensity score analysis confirmed independent mortality predictors included hyperlactatemia (aOR 2.21), altered consciousness (aOR 2.09), hypotension (aOR 1.87), and leukopenia (aOR 1.79). ICU admission rate decreased from 58% to 24% over the study period. This 16-year analysis shows that comprehensive hospital-wide sepsis protocols achieve sustained mortality reduction with improved resource utilization efficiency. These findings support implementing comprehensive sepsis protocols as an effective strategy for improving sepsis outcomes.
publishDate 2025
dc.date.none.fl_str_mv 2025
2025-08-14
2025
2025-08-14
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.13003/25935
url https://hdl.handle.net/20.500.13003/25935
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Docusalut
instname:Conselleria de Salut i Consum del Govern de les Illes Balears
instname_str Conselleria de Salut i Consum del Govern de les Illes Balears
reponame_str Docusalut
collection Docusalut
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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