An investigation of sepsis surveillance and emergency treatment on patient mortality outcomes: an observational cohort study

Objective. To determine the prevalence of initiating the sepsis 3-hour bundle of care and estimate effects of bundle completion on risk-adjusted mortality among ED patients screened-in by electronic surveillance. Materials and Methods. This was a multiple center observational cohort study conducted in 2016. The study population was comprised of patients screened-in by St. John Sepsis Surveillance Agent within four hours of ED arrival, had a sepsis bundle initiated, and admitted to hospital. We built multivariable logistic regression models to estimate impact of a 3-hour bundle completed within three hours of arrival on mortality outcomes. Results. Approximately 3% ED patients were screened-in by electronic surveillance within four hours of arrival and admitted to hospital. Nearly 7 in 10 (69%) patients had a bundle initiated, with most bundles completed within three hours of arrival. The fully-adjusted risk model achieved good discrimination on mortality outcomes (AUROC = .82, 95% CI...