Activity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years

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dc.contributor.authorBorges-Sa, Marcio
dc.contributor.authorMartin-Martinez, Elena
dc.contributor.authorAranda, Maria
dc.contributor.authorSocias, Antonia
dc.contributor.authorTejada, Sofia
dc.contributor.authordel Castillo, Alberto
dc.contributor.authorGarau, Margarita
dc.contributor.authorPérez de Amezaga, Luis
dc.contributor.authorMena, Joana
dc.contributor.authorGiglio, Andres
dc.coverage.spatialSuiza
dc.date.accessioned2026-08-18T15:52:12Z
dc.date.available2026-08-18T15:52:12Z
dc.date.issued0030-07-26
dc.description.abstractBackground. 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.citationAntibiotics, Vol. 15, N° 8 (2026) págs. 1–19
dc.identifier.doihttps://doi.org/10.3390/antibiotics15080737
dc.identifier.issne2079-6382
dc.identifier.orcidhttps://orcid.org/0000-0002-0533-4531
dc.identifier.urihttps://hdl.handle.net/20.500.12254/7710
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.titleActivity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years
dc.typeArticle
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