From: Association of annual hospital septic shock case volume and hospital mortality
Septic shock case volume quartile | p valuea | ||||
---|---|---|---|---|---|
First quartile, 1–13 cases per year | Second quartile, 14–32 cases per year | Third quartile, 33–75 cases per year | Fourth quartile, > 75 cases per year | ||
Hospitals and ICUs | |||||
Number of hospitals, n | 475 | 468 | 478 | 481 | |
Geographic location, n (%) | 0.763 | ||||
East | 193 (40) | 179 (38) | 191 (39) | 204 (42) | |
Middle | 102 (21) | 118 (25) | 104 (21) | 114 (23) | |
West | 158 (33) | 150 (32) | 162 (33) | 136 (28) | |
Northeast | 22 (4) | 21 (4) | 21 (4) | 27 (5) | |
Type of hospitals, n (%) | 0.001 | ||||
Public | 432 (91) | 430 (92) | 440 (92) | 466 (97) | |
Private | 43 (9) | 38 (8) | 38 (8) | 15 (3) | |
Level of hospitals, n (%) | < 0.0001 | ||||
Tertiary | 139 (29) | 226 (48) | 277 (57) | 388 (80) | |
Secondary | 331 (69) | 238 (50) | 199 (41) | 91 (18) | |
Healthcare facility volume, n | |||||
Hospital volume per year | 18,616 ± 16,069 | 26,460 ± 27,795 | 34,297 ± 28,557 | 60,618 ± 55,195 | < 0.0001 |
ICU volume per year | 414 ± 1509 | 597 ± 2337 | 641 ± 586 | 1463 ± 2119 | < 0.0001 |
Hospital bed days/1000 patients | 153 ± 102 | 224 ± 211 | 331 ± 1036 | 522 ± 1144 | < 0.001 |
ICU bed days/1000 patients | 3 ± 13 | 3 ± 4 | 6 ± 33 | 11 ± 37 | < 0.0001 |
Guideline compliance, % | |||||
3-h Surviving Sepsis Campaign bundle | 73 ± 32 | 79 ± 25 | 78 ± 25 | 78 ± 24 | 0.004 |
6-h Surviving Sepsis Campaign bundle | 71 ± 33 | 77 ± 27 | 77 ± 27 | 76 ± 24 | 0.002 |
Microbiology specimen collection before antibiotic therapy, % | 68 ± 34 | 75 ± 27 | 77 ± 29 | 80 ± 24 | < 0.001 |
Protocolized Infection control, n (%) | |||||
Infection management | 434 (91) | 448 (96) | 466 (97) | 467 (97) | < 0.001 |
Infection training | 433 (91) | 433 (93) | 459 (96) | 467 (97) | < 0.001 |
Infection monitor | 435 (92) | 439 (94) | 466 (97) | 472 (98) | < 0.001 |
Infection contingency plan | 443 (93) | 445 (95) | 467 (98) | 471 (98) | < 0.001 |
Infection performance | 318 (67) | 325 (70) | 363 (76) | 350 (73) | 0.015 |
ICU mortality rate, % | 11 ± 10 | 12 ± 10 | 12 ± 10 | 12 ± 9 | 0.530 |
Septic shock cases | |||||
Female, % | 45 ± 20 | 40 ± 11 | 40 ± 10 | 41 ± 9 | < 0.0001 |
Age group, % | 0 ± 0 | 0 ± 0 | 0 ± 0 | 0 ± 0 | |
Less than 18 years old | 3 ± 15 | 2 ± 10 | 3 ± 13 | 2 ± 8 | 0.263 |
18–30 years old | 3 ± 13 | 2 ± 4 | 3 ± 4 | 3 ± 4 | 0.027 |
31–40 years old | 4 ± 11 | 4 ± 6 | 5 ± 6 | 6 ± 5 | < 0.0001 |
41–50 years old | 8 ± 14 | 9 ± 9 | 10 ± 8 | 10 ± 6 | < 0.0001 |
51–60 years old | 15 ± 18 | 16 ± 11 | 17 ± 10 | 17 ± 8 | 0.070 |
61–70 years old | 25 ± 22 | 25 ± 13 | 25 ± 11 | 23 ± 9 | 0.062 |
71–80 years old | 26 ± 23 | 24 ± 13 | 23 ± 12 | 23 ± 11 | 0.016 |
More than 80 years old | 18 ± 22 | 18 ± 15 | 16 ± 14 | 15 ± 11 | 0.026 |
Site of infection, % | |||||
Bloodstream | 16 ± 26 | 17 ± 21 | 16 ± 20 | 15 ± 15 | 0.850 |
Catheter related bloodstream | 4 ± 12 | 5 ± 10 | 3 ± 7 | 3 ± 5 | 0.043 |
Lung | 44 ± 31 | 42 ± 22 | 41 ± 23 | 41 ± 22 | 0.294 |
Abdomen | 18 ± 22 | 17 ± 14 | 18 ± 14 | 16 ± 11 | 0.113 |
Urinary tract | 14 ± 20 | 12 ± 11 | 13 ± 11 | 12 ± 9 | 0.378 |
Central nervous system | 2 ± 9 | 2 ± 4 | 2 ± 3 | 3 ± 4 | 0.043 |
Biliary tract | 7 ± 14 | 7 ± 7 | 7 ± 6 | 7 ± 6 | 0.720 |
Gastrointestinal tract | 5 ± 11 | 6 ± 8 | 7 ± 9 | 6 ± 7 | 0.018 |
Bone | 0 ± 5 | 0 ± 1 | 0 ± 1 | 0 ± 0 | 0.205 |
Skin and soft tissue | 3 ± 11 | 3 ± 5 | 3 ± 4 | 3 ± 3 | 0.196 |
Others | 2 ± 10 | 2 ± 6 | 2 ± 4 | 3 ± 6 | 0.177 |
Proportion of APACHE II score ≥ 15, % | 57 ± 27 | 61 ± 24 | 65 ± 23 | 62 ± 24 | < 0.0001 |
Hospital mortality of septic shock cases, % | 24 ± 26 | 24 ± 20 | 20 ± 17 | 18 ± 15 | < 0.0001 |