| All patients (n= 556) | Lactate clearance (n= 331) | No lactate clearance (n= 225) | P value |
---|---|---|---|---|
Age (years) | 63 (50 to 74) | 61 (50 to 71) | 65 (52 to 78) | <0.01 |
Gender | Â | Â | Â | Â |
   Female | 226 (40.6%) | 133 (40.2%) | 93 (41.3%) | 0.79 |
   Male | 330 (59.4%) | 198 (59.8%) | 132 (58.7%) |  |
Septic shock | 373 (67.1%) | 232 (70.1%) | 141 (62.7%) | 0.07 |
APACHE II score | 22 (16 to 27) | 19 (14 to 25) | 25 (20 to 30) | <0.01 |
APACHE II predicted mortality (%) | 41.6 (20.4 to 59.7) | 34.8 (20.4 to 56.1) | 52.5 (31.5 to 72.6) | <0.01 |
In-hospital mortality | 166 (29.9%) | 68 (20.5%) | 98 (43.6%) | <0.01 |
Primary SSC Bundle item completion | 192 (34.5%) | 174 (52.6%) | 18 (8.0%) | <0.01 |
   Lactate measured | 488 (87.8%) | 331 (100.0%) | 157 (70.4%) | <0.01 |
   Blood cultures before antibiotics | 514 (92.4%) | 313 (94.6%) | 201 (89.3%) | 0.02 |
   Antibiotics administered by 3 hours | 537 (96.6%) | 324 (97.9%) | 213 (94.7%) | 0.04 |
   Fluid bolus given | 506 (91.0%) | 310 (93.7%) | 196 (87.1%) | 0.01 |
   Achieve CVP >8 mmHg by 6 hours | 319 (57.4%) | 232 (70.1%) | 87 (38.7%) | <0.01 |
   Achieve MAP >65 mmHg by 6 hours | 530 (95.3%) | 326 (98.5%) | 204 (91.5%) | <0.01 |
   Achieve ScvO2 >70% by 6 hours | 250 (45.0%) | 213 (64.4%) | 37 (16.4%) | <0.01 |
Care team model | Â | Â | Â | Â |
   Team | 190 (34.2%) | 164 (49.6%) | 26 (11.6%) | <0.01 |
   Nonteam | 366 (65.8%) | 167 (50.5%) | 199 (88.4%) |  |
Mechanical ventilation | 295 (53.1%) | 143 (43.2%) | 152 (67.6%) | <0.01 |
Therapies in the ED | Â | Â | Â | Â |
   Amount of fluids (ml) | 1, 500 (1, 000 to 2, 550) | 1, 533 (1, 000 to 3, 000) | 1, 350 (850 to 2, 300) | <0.01 |
   Vasopressor usea | 306 (55.0%) | 188 (56.8%) | 118 (52.4%) | 0.31 |
   Inotrope useb | 222 (39.9%) | 134 (43.7%) | 88 (40.6%) | 0.48 |
   Transfusion use | 21 (3.8%) | 12 (3.6%) | 9 (4.0%) | 0.82 |
Therapies in the ICU | Â | Â | Â | Â |
   Amount of fluids (ml) | 6, 268 (3, 800 to 10, 200) | 7, 943 (5, 200 to 11, 345) | 4, 596 (3, 060 to 7, 100) | <0.01 |
   Vasopressor usea | 383 (68.9%) | 223 (67.4%) | 160 (71.1%) | 0.35 |
   Inotrope useb | 251 (45.1%) | 141 (44.5%) | 110 (49.8%) | 0.23 |
   Transfusion use | 116 (20.9%) | 65 (19.6%) | 51 (22.7%) | 0.39 |
Length of stay | Â | Â | Â | Â |
   ED (hours) | 5 (3 to 9) | 4 (3 to 6) | 6 (4 to 15) | <0.01 |
   ICU (days) | 4 (2 to 8) | 4 (2 to 7) | 4 (1 to 9) | 0.53 |
   Hospital (days) | 9 (4 to 16) | 9 (5 to 16) | 9 (3 to 17) | 0.07 |
Hemodynamics | Â | Â | Â | Â |
   Baseline CVP (mmHg) | 10 (7 to 13) | 9 (7 to 12) | 11 (6 to 15) | 0.04 |
   Six-hour CVP (mmHg) | 10 (8 to 14) | 10 (8 to 13) | 10 (7 to 15) | 0.20 |
   Baseline MAP (mmHg) | 70 (56 to 86) | 66 (56 to 83) | 73 (57 to 90) | 0.01 |
   Six-hour MAP (mmHg) | 78 (69 to 87) | 80 (72 to 87) | 73 (65 to 84) | <0.01 |
   Baseline ScvO2 (%) | 77 (69 to 82) | 78 (70 to 82) | 73 (57 to 78) | 0.01 |
   Six-hour ScvO2 (%) | 77 (71 to 82) | 77 (72 to 82) | 72 (60 to 79) | 0.01 |
Laboratories | Â | Â | Â | Â |
   Lactate (mmol/l) | 4.1 (2.2 to 6.3) | 3.8 (1.9 to 5.8) | 4.4 (3.0 to 6.9) | <0.01 |
   Blood culture positive | 180 (32.4%) | 99 (29.9%) | 81 (36.0%) | 0.25 |
   Culture positive | 191 (34.4%) | 103 (31.1%) | 88 (39.1%) | 0.05 |
   White blood count (103/mm3) | 13.4 (6.9 to 20.4) | 13.4 (7.2 to 20.2) | 13.3 (6.7 to 22.0) | 0.92 |
   Hemoglobin (g/dl) | 11.6 (9.7 to 13.2) | 11.5 (9.6 to 13.2) | 11.6 (9.8 to 13.4) | 0.80 |
   Platelet count (x109/l) | 150.0 (68.0 to 246.0) | 162.0 (70.0 to 254.0) | 136.0 (67.0 to 219.0) | 0.07 |
   International Normalized Ratio | 1.4 (1.2 to 1.7) | 1.3 (1.1 to 1.5) | 1.5 (1.2 to 1.8) | <0.01 |
   Creatinine (mg/dl) | 2.0 (1.3 to 3.1) | 2.0 (1.2 to 2.9) | 2.0 (1.4 to 3.1) | 0.24 |
   Total bilirubin (mg/dl) | 1.1 (0.7 to 2.4) | 1.0 (0.6 to 2.2) | 1.4 (0.7 to 3.4) | <0.01 |
   Albumin (g/dl) | 3.0 (2.5 to 3.6) | 3.1 (2.6 to 3.7) | 2.8 (2.3 to 3.5) | 0.01 |
   PaO2/FiO2 ratio | 163.0 (86.0 to 320.7) | 251.1 (95.0 to 391.0) | 125.5 (77.0 to 217.0) | <0.01 |
Source of infection | Â | Â | Â | 0.13 |
   Pneumonia | 233 (41.9%) | 136 (41.1%) | 97 (43.1%) |  |
   Urinary tract infection | 93 (16.7%) | 64 (19.3%) | 29 (12.9%) |  |
   Intra-abdominal | 108 (19.4%) | 68 (20.5%) | 40 (17.8%) |  |
   Skin/cellulitis | 33 (5.9%) | 17 (5.1%) | 16 (7.1%) |  |
   Other/unknown | 89 (16.0%) | 46 (13.9%) | 43 (19.1%) |  |