Decoding sepsis: a 16-year retrospective analysis of activation patterns, mortality predictors, and outcomes from a hospital-wide sepsis protocol

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dc.contributor.authorBorges-Sa, Marcio
dc.contributor.authorGiglio, Andrés
dc.contributor.authorAranda, Maria
dc.contributor.authorSocias, Antonia
dc.contributor.authorCastillo, Alberto del
dc.contributor.authorMena, Joana
dc.contributor.authorFranco, Sara
dc.contributor.authorOrtega, María
dc.contributor.authorNieto, Yasmina
dc.contributor.authorEstrada, Victor
dc.contributor.authorRica, Roberto de la
dc.date.accessioned2025-08-26T14:28:19Z
dc.date.available2025-08-26T14:28:19Z
dc.date.issued2025-08-14
dc.description.abstractBackground: 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. Methods: 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. Results: 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 (p < 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. Conclusions: 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.
dc.identifier.citationJournal of Clinical Medicine, Vol. 14, N° 16, 5759 (2025) p. 1-17.
dc.identifier.doihttps://doi.org/10.3390/jcm14165759
dc.identifier.issn2077-0383
dc.identifier.orcidhttps://orcid.org/0000-0002-0533-4531
dc.identifier.urihttps://hdl.handle.net/20.500.12254/4279
dc.language.isoen
dc.publisherMDPI
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectSepsis
dc.subjectSeptic shock
dc.subjectProtocol activation
dc.subjectEarly detection
dc.subjectMortality predictors
dc.subjectResource utilization
dc.subjectHospital wide
dc.titleDecoding sepsis: a 16-year retrospective analysis of activation patterns, mortality predictors, and outcomes from a hospital-wide sepsis protocol
dc.typeArticle
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