Table 2 Outcomes throughout the intervention in the whole population and according to the success of the institutions
Variables | Baseline (n = 384) | Second quarter (n = 288) | Third quarter (n = 422) | Fourth quarter (n = 531) | Fifth quarter (n = 563) | Sixth quarter (n = 492) | Seventh quarter (n = 398) | Eighth quarter (n = 357) | p Valuea |
|---|---|---|---|---|---|---|---|---|---|
Hospital mortality | |||||||||
All institutions | 226 (58.9) | 177 (61.5) | 236 (55.9) | 278 (52.4) | 280 (49.7) | 250 (50.8) | 183 (46.0) | 166 (46.5) | <0.0001 |
Successful institutions | 113 (51.4) | 71 (60.2) | 122 (50.4) | 103 (43.3) | 117 (45.0) | 78 (36.1) | 77 (36.8) | 114 (41.0) | <0.0001 |
Nonsuccessful institutions | 113 (68.9) | 106 (62.4) | 114 (63.3) | 175 (59.7) | 163 (53.8) | 172 (62.3) | 106 (56.1) | 52 (65.8) | |
Hospital mortality: sepsis | |||||||||
All institutions | 85 (42.7) | 76 (47.8) | 108 (43.7) | 155 (45.1) | 125 (35.9) | 118 (39.3) | 97 (35.9) | 85 (37.3) | 0.028 |
Successful institutions | 36 (31.9) | 35 (52.2) | 56 (39.2) | 60 (36.1) | 64 (35.2) | 33 (24.8) | 43 (28.5) | 64 (33.3) | <0.0001 |
Nonsuccessful institutions | 49 (57.0) | 41 (44.6) | 52 (50.0) | 95 (53.4) | 61 (36.7) | 85 (50.9) | 54 (45.4) | 21 (58.3) | |
Hospital mortality: septic shock | |||||||||
All institutions | 141 (76.2) | 101 (78.3) | 128 (73.1) | 123 (65.8) | 155 (72.1) | 132 (68.8) | 86 (67.2) | 81 (62.8) | 0.0020 |
Successful institutions | 77 (72.0) | 36 (70.6) | 66 (66.7) | 43 (59.7) | 53 (67.9) | 45 (54.2) | 34 (58.6) | 50 (58.1) | <0.0001 |
Nonsuccessful institutions | 64 (82.1) | 65 (83.3) | 62 (81.6) | 80 (69.6) | 102 (74.5) | 87 (79.8) | 52 (74.3) | 31 (72.1) | |
Hospital mortality: ED | |||||||||
All institutions | 94/184 (51.1) | 69/114 (60.5) | 91/179 (50.8) | 104/224 (46.4) | 109/247 (44.1) | 97/232 (41.8) | 78/201 (38.8) | 113/248 (45.6) | 0.003 |
Successful institutions | 63/136 (46.3) | 31/55 (56.4) | 50/108 (46.3) | 38/110 (34.5) | 53/138 (38.4) | 35/116 (30.2) | 34/113 (30.1) | 82/207 (39.6) | <0.0001 |
Nonsuccessful institutions | 31/48 (64.6) | 38/59 (64.4) | 41/71 (57.7) | 66/114 (57.9) | 56/109 (51.4) | 62/116 (53.4) | 44/88 (50.0) | 31/41 (75.6) | |
Hospital mortality: wards | |||||||||
All institutions | 99/145 (68.3) | 71/129 (55.0) | 116/184 (63.0) | 128/221 (57.9) | 116/219 (53.0) | 101/174 (58.0) | 67/141 (47.5) | 28/65 (43.1) | 0.0001 |
Successful institutions | 29/48 (60.4) | 26/42 (61.9) | 54/91 (59.3) | 41/77 (53.2) | 33/67 (49.3) | 15/47 (31.9) | 22/60 (36.7) | 11/35 (31.4) | <0.0001 |
Nonsuccessful institutions | 70/97 (72.2) | 45/87 (51.7) | 62/93 (66.7) | 87/144 (60.4) | 83/152 (54.6) | 86/127 (67.7) | 45/81 (55.6) | 17/30 (56.7) | |
Hospital mortality: ICU | |||||||||
All institutions | 33/55 (60.0) | 37/45 (82.2) | 29/59 (49.2) | 46/86 (53.5) | 55/97 (56.7) | 52/86 (60.5) | 38/56 (67.9) | 25/44 (56.8) | 0.921 |
Successful institutions | 21/36 (58.3) | 14/21 (66.7) | 18/43 (41.9) | 24/51 (47.1) | 31/55 (56.4) | 28/53 (52.8) | 21/36 (58.3) | 21/36 (58.3) | 0.001 |
Nonsuccessful institutions | 12/19 (63.2) | 23/24 (95.8) | 11/16 (68.8) | 22/35(62.9) | 24/42 (57.1) | 24/33 (72.7) | 17/20 (85.0) | 4/8 (50.0) | |
Percentage of sepsis | |||||||||
All institutions | 199 (51.8) | 159 (55.2) | 247 (58.5) | 344 (64.8) | 348 (61.8) | 300 (61.0) | 270 (67.8) | 228 (63.9) | <0.0001 |
Successful institutions | 113 (51.4) | 67 (56.8) | 143 (59.1) | 166 (69.7) | 182 (70.0) | 133 (61.6) | 151 (72.2) | 192 (69.1) | <0.0001 |
Nonsuccessful institutions | 86 (52.4) | 92 (54.1) | 104 (57.8) | 178 (60.8) | 166 (54.8) | 167 (60.5) | 119 (63.0) | 36 (45.6) | |
Time to sepsis diagnosis, h | |||||||||
All institutions | 5.0 (1.5–17.0) | 5.3 (1.5–19.5) | 3.0 (0.9–10.9) | 2.1 (0.9–7.7) | 2.2 (0.8–8.7) | 2.0 (0.7–6.8) | 1.3 (0.6–4.0) | 1.0 (0.4–2.1) | <0.0001 |
Successful institutions | 5.7 (1.7–14.8) | 5.2 (1.6–14.8) | 2.6 (0.9–8.0) | 1.7 (0.8–5.3) | 2.0 (0.8–5.7) | 1.1 (0.5–3.0) | 1.0 (0.5–2.6) | 0.8 (0.4–2.0) | <0.0001 |
Nonsuccessful institutions | 4.0 (1.3–18.0) | 6.3 (1.5–22.0) | 4.7 (1.0–13.8) | 3.5 (1.0–12.5) | 2.9 (0.8–13.5) | 3.7 (1.0–14.1) | 2.5 (1.0–8.6) | 2.0 (1.0–7.5) | |
APACHE II score, points | |||||||||
All institutions | 23 (18–30) | 23 (18–29) | 20 (15–27) | 19 (15–24) | 18 (14–22) | 18 (14–23) | 17 (13–22) | 17 (13–21) | <0.0001 |
Successful institutions | 21 (17–28) | 22 (18–29) | 20 (15–25) | 18 (14–23) | 17 (13–21) | 18 (14–22.2) | 17 (12–21) | 16.5 (13–21) | <0.0001 |
Nonsuccessful institutions | 26 (20–31) | 23 (18–28.8) | 22 (15.5–28.5) | 20 (15–26) | 18 (14–22) | 19 (14–23) | 17 (13–22) | 19 (15–23.5) | |
SOFA score, points | |||||||||
All institutions | 8 (5–12) | 8 (5–11) | 7 (5–11) | 7 (4–11) | 7 (4–11) | 7 (4–10) | 6 (4–9) | 6 (4–10) | <0.0001 |
Successful institutions | 7 (4–11) | 8 (5–11) | 7 (4–10) | 6 (3–9) | 6 (3–10) | 7 (4–10) | 6 (3–9) | 6 (3–9) | <0.0001 |
Nonsuccessful institutions | 9 (6–12) | 8 (5–11) | 8 (5–12) | 8 (5–11) | 8 (5–12) | 7 (5–11) | 6 (4–9) | 9 (6–12) | |
Number of organ dysfunctions | |||||||||
All institutions | 2 (2–3) | 2 (2–3) | 2 (2–3) | 2 (1–3) | 2 (1–2) | 2 (1–3) | 2 (1–2) | 2 (1–3) | <0.0001 |
Successful institutions | 2 (2–3) | 2 (2–3) | 2 (2–3) | 2 (1–3) | 2 (1–2) | 2 (1–2) | 2 (1–2) | 2 (1–2) | <0.0001 |
Nonsuccessful institutions | 2 (2–3) | 2 (2–3) | 3 (2–3) | 2 (2–3) | 2 (1–3) | 2 (1–3) | 2 (1–3) | 2 (2–3) | |
Compliance with the first three itemsb | |||||||||
All institutions | 46 (12.0) | 37 (12.8) | 74 (17.5) | 162 (30.5) | 183 (32.5) | 163 (33.1) | 149 (37.4) | 151 (42.3) | <0.0001 |
Successful institutions | 21 (9.5) | 11 (9.3) | 37 (15.3) | 70 (29.4) | 77 (29.6) | 72 (33.3) | 70 (33.5) | 102 (36.7) | <0.0001 |
Nonsuccessful institutions | 25 (15.2) | 26 (15.3) | 37 (20.6) | 92 (31.4) | 106 (35.0) | 91 (33.0) | 79 (41.8) | 49 (62.0) | |
Full compliance with 6-h bundle | |||||||||
All institutions | 22 (5.7) | 20 (6.9) | 41 (9.7) | 89 (16.8) | 99 (17.6) | 82 (16.7) | 92 (23.1) | 82 (23.0) | <0.0001 |
Successful institutions | 10 (4.5) | 8 (6.8) | 25 (10.3) | 41 (17.2) | 37 (14.2) | 33 (15.3) | 44 (21.1) | 59 (21.2) | 0.016 |
Nonsuccessful institutions | 12 (7.3) | 12 (7.1) | 16 (8.9) | 48 (16.4) | 62 (20.5) | 49 (17.8) | 48 (25.4) | 23 (29.1) | |
Compliance with fluids and vasopressors | |||||||||
All institutions | 210 (60.9) | 156 (62.2) | 271 (76.6) | 318 (75.2) | 355 (79.1) | 323 (81.4) | 244 (82.7) | 254 (91.0) | <0.0001 |
Successful institutions | 125 (61.0) | 55 (51.9) | 164 (76.6) | 150 (79.4) | 164 (82.4) | 138 (82.6) | 139 (89.7) | 203 (95.3) | <0.0001 |
Nonsuccessful institutions | 85 (60.7) | 101 (69.7) | 107 (76.4) | 168 (71.8) | 191 (76.4) | 185 (80.4) | 105 (75.0) | 51 (77.3) | |
Compliance with antibiotics | |||||||||
All institutions | 218 (56.8) | 164 (56.9) | 271 (64.2) | 358 (67.4) | 386 (68.6) | 347 (70.5) | 274 (68.8) | 263 (73.7) | <0.0001 |
Successful institutions | 125 (56.8) | 70 (59.3) | 167 (69.0) | 159 (66.8) | 183 (70.4) | 158 (73.1) | 143 (68.4) | 205 (73.7) | 0.1072 |
Nonsuccessful institutions | 93 (56.7) | 94 (55.3) | 104 (57.8) | 199 (67.9) | 203(67.0) | 189 (68.5) | 131 (69.3) | 58 (73.4) | |