Early Sepsis Control associated with Lower 90-Day Mortality: JAMA

A group of researchers conducted a study to determine the relationship between time to source control and patient outcomes in community-acquired sepsis. Multi-hospital integrated healthcare system cohort study of hospitalized adults with community-acquired sepsis (January 1, 2013 - December 31, 2017) identified by Sepsis-3 who underwent source control procedures. Follow-up continued until January 1, 2019, and data analyzes were completed on March 17, 2022.

Results:

• Of 4962 patients with sepsis, source control was performed at a median (IQR) of 15.4 hours after the onset of sepsis, and source control was performed within 6 hours in 1315 patients (27%).

• Crude mortality at 90 days was similar for early and late source control.

• In multivariate models, early source control was associated with reduced risk-adjusted 90-day mortality rates.

• This association was greater between gastrointestinal and abdominal and soft tissue interventions compared to orthopaedic and cranial interventions.

Therefore, source control within 6 hours of the onset of community-acquired sepsis was associated with a reduced risk-adjusted 90-day mortality rate. Prioritizing rapid identification of septic foci and initiation of source control interventions can reduce the number of preventable deaths in patients with sepsis.

Reference:

JAMA Surgery Source Reference: Reitz KM, et al "Association between time to source control in sepsis and 90-day mortality" JAMA Surg 2022;

DOI: 10.1001/jamasurg.2022.2761.