Activity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years
| dc.contributor.author | Borges-Sa, Marcio | |
| dc.coverage.spatial | Suiza | |
| dc.date.accessioned | 2026-08-18T15:52:12Z | |
| dc.date.available | 2026-08-18T15:52:12Z | |
| dc.date.issued | 2024-07-26 | |
| dc.description.abstract | Background. Sepsis is a leading, time-dependent cause of in-hospital death, and guidelines now prioritize organized care such as code-sepsis protocols. Yet little is known about the long-term activity, organization and outcomes of permanent, hospital-scale programs. We characterized the activity of a hospital-wide multidisciplinary sepsis unit (MSU) over thirteen years and evaluated mortality trends. Methods. Retrospective cohort study using the registry of a hospital-wide MSU (2011–2023). The analysis unit was the sepsis event. Activity, referral pathways, interventions, follow-up and mortality were analyzed; temporal trends used multivariable logistic regression and standardized mortality ratios (SMR). Results. The unit attended 10,874 patients across 15,723 events and 50,925 consultations (median age 67; 59.3% men), referred mainly through the sepsis code (45.0%) and, increasingly, proactive early-warning detection (15.2%). An antibiotic change was recommended in 57.2% of events, and 89.8% of all suggested changes were implemented. Follow-up was sustained (median 3 visits; 61.8%). In-hospital mortality was 7.6%, and 11.8% in protocol-confirmed sepsis. Crude mortality did not fall, but severity rose (organ dysfunctions 1.67 to 2.72; septic shock 8 to 13%; both p < 0.001) with stable age; after adjustment the calendar-year effect disappeared (adjusted OR 1.00/year, p = 0.70) and the SMR stayed near 1.0, including pandemic years. Age, ICU admission (OR 2.65) and organ-dysfunction count (OR 1.37) independently predicted death. Conclusions. Over thirteen years, this hospital-wide MSU delivered large-scale, multi-channel, longitudinal care to an increasingly severe population while maintaining stable risk-adjusted mortality, supporting the long-term feasibility of a model integrating early detection, multidisciplinary decision-making, antimicrobial stewardship and follow-up. | |
| dc.identifier.citation | Antibiotics, Vol. 15, N° 8 (2026) págs. 1–19 | |
| dc.identifier.doi | https://doi.org/10.3390/antibiotics15080737 | |
| dc.identifier.issne | 2079-6382 | |
| dc.identifier.orcid | https://orcid.org/0000-0002-0533-4531 | |
| dc.identifier.uri | https://hdl.handle.net/20.500.12254/7710 | |
| dc.language.iso | eng | |
| dc.publisher | MDPI | |
| dc.rights | Acceso abierto | |
| dc.rights.license | Atribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL) | |
| dc.rights.uri | https://creativecommons.org/licenses/by-nc-sa/3.0/cl/ | |
| dc.subject | Sepsis | |
| dc.subject.nabs | 07 - Protección y mejora de la salud humana | |
| dc.subject.ods | ODS 3 - Salud y bienestar | |
| dc.subject.oecd | 3.2.28 - Otros Temas de Medicina Clínica||3.3.9 - Epidemiología | |
| dc.title | Activity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years | |
| dc.type | Article | |
| dc.type.coar | http://purl.org/coar/resource_type/c_6501 |