Author | Machado, Flavia R. | |
Author | Ferreira, Elaine M. | |
Author | Sousa, Juliana Lubarino | |
Author | Silva, Carla | |
Author | Schippers, Pierre | |
Author | Pereira, Adriano | |
Author | Cardoso, Ilusca M. | |
Author | Salomão, Reinaldo | |
Author | Japiassu, Andre | |
Author | Akamine, Nelson | |
Author | Mazza, Bruno F. | |
Author | Assunção, Murillo S. C. | |
Author | Fernandes, Haggeas S. | |
Author | Bossa, Aline | |
Author | Monteiro, Mariana B. | |
Author | Caixeita, Noemi | |
Author | Azevedo, Luciano C. P. | |
Author | Silva, Eliezer | |
Access date | 2019-07-26T13:15:21Z | |
Available date | 2019-07-26T13:15:21Z | |
Document date | 2017 | |
Citation | MACHADO, Flavia R. et al. Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients. Critical Care Medicine, v. 45, n. 10, p. 1650-1659, Oct. 2017. | pt_BR |
ISSN | 0090-3493 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/34439 | |
Description | André Japiassu. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. | pt_BR |
Language | eng | pt_BR |
Publisher | Lippincott, Williams & Wilkins | pt_BR |
Rights | open access | pt_BR |
Title | Quality improvement initiatives in sepsis in an emerging country: does the institution's mainsource of income influence the results? An analysis of 21,103 patients | pt_BR |
Type | Article | pt_BR |
DOI | 10.1097/CCM.0000000000002585 | |
Abstract | Objective: We aimed to assess the results of a quality improvement initiative in sepsis in an emerging setting and to analyze it according to the institutions’ main source of income (public or private). Design: Retrospective analysis of the Latin American Sepsis Institute database from 2005 to 2014. Settings: Brazilian public and private institutions. Patients: Patients with sepsis admitted in the participant institutions. Interventions: The quality improvement initiative was based on a multifaceted intervention. The institutions were instructed to collect data on 6-hour bundle compliance and outcomes in patients with sepsis in all hospital settings. Outcomes and compliance was measured for eight periods of 6 months each, starting at the time of the enrollment in the intervention. The primary outcomes were hospital mortality and compliance with 6-hour bundle. Measurements and Main Results: We included 21,103 patients; 9,032 from public institutions and 12,071 from private institutions. Comparing the first period with the eigth period, compliance with the 6-hour bundle increased from 13.5% to 58.2% in the private institutions (p < 0.0001) and from 7.4% to 15.7% in the public institutions (p < 0.0001). Mortality rates significantly decreased throughout the program in private institutions, from 47.6% to 27.2% in the eighth period (adjusted odds ratio, 0.45; 95% CI, 0.32–0.64). However, in the public hospitals, mortality diminished significantly only in the first two periods. Conclusion: This quality improvement initiative in sepsis in an emerging country was associated with a reduction in mortality and with improved compliance with quality indicators. However, this reduction was sustained only in private institutions. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Affilliation | Latin American Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
Subject | Mortality | pt_BR |
Subject | Sepsis bundles | pt_BR |
Subject | Sepsis | pt_BR |
Subject | Septic shock | pt_BR |
Subject | Quality improvement | pt_BR |
e-ISSN | 1530-0293 | |
Embargo date | 2020-07-26 | |