Sepsis-related mortality down in New York as compliance with 3- & 6-hour bundle protocols increases

New York's statewide mandatory initiative for sepsis treatment increased compliance with sepsis bundles, leading to a decrease in sepsis-related mortality, according to a study published in American Journal of Respiratory and Critical Care Medicine.

The state mandate, called Rory's Regulations, was implemented in 2013, after 12-year-old Rory Staunton died from undiagnosed sepsis in 2012.

Researchers studied 91,357 hospitalizations from 183 hospitals in New York, reported to the New York State Department of Health from April 1, 2014, to June 30, 2016. The department of health required all hospitals to submit and follow certain sepsis identification and treatment protocols, including elements of three-and six-hour sepsis bundles such as lactate measurement, early blood cultures and antibiotic administration, fluids and vasopressors.

Of 91,357 hospitalizations, caregivers initiated the sepsis protocol for 74,293, or 81.3 percent. Among the 74,293 hospitalizations were sepsis protocol was initiated, three-hour bundle compliance increased from 53.4 percent to 64.7 percent during the study period

For the 35,307 patients eligible for the six-hour bundle, compliance increased from 23.9 percent to 30.8 percent.

Additionally, risk-adjusted mortality decreased from 28.8 percent to 24.4 percent among patients who underwent a sepsis protocol.

A previous study found that completion of the sepsis protocol within one hour decreased the odds of death by 40 percent.

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