The Lower Sepsis Mortality Rates

📄 Words:	897
📝 Subject:	Healthcare Research
📑 Pages:	4
📚 Topics:	Antibiotic

First Author (Year)	Conceptual Framework	Design/ Method	Major Variables Studies (and Their Definitions)	Sample and Setting	Measurement	Data Analysis	Findings	Appraisal: Worth to Practice
Luhr (2019)	Epidemiological data has presented the increasing rates of sepsis incidences along with the reduction in mortality numbers. The meta-analysis was conducted to examine the possible change in sepsis mortality rates over time.	A meta-analysis.	The independent variable is the septic shock or severe sepsis incidences, and the dependent variable is the change of sepsis mortality rates between 2002 and 2016.	The meta-analysis included 44 articles on sepsis, enrolling 13315 patients with this health problem between 1991 and 2003.	Nominal scale.	In 22 years, the sepsis mortality rates decreased by 0.42% annually, which resulted in an overall decline of 9.24%.	The analysis demonstrated a declination in 28-day mortality in septic shock and severe sepsis patients during 22 years: from 1991 till 2013.	Yes.
Fuchs (2017)	The increased evidence of beta-blockade reduces mortality rates in patients with severe sepsis. It is questioned whether doctors should continue oral beta-blocker therapy for patients with septic shock or severe sepsis.	A secondary analysis.	The independent variable is the incidence of sepsis, and the dependent variable is the reduced mortality due to the oral beta-blockade treatments.	The analysis included 296 patients struggling from severe sepsis along with ongoing beta-blockade treatment. The oral beta-blocker medication was stopped in the acute phase of sepsis in 129 patients and continued in 167 analysis participants.	Nominal scale.	Continuation of a beta-blocker therapy resulted in reduced 28-day and 90-day hospital mortality rates — 40.7%. However, the discontinuation of the therapy proved to decrease mortality rates significantly more (52.7%). The analysis identified the continued beta-blocker therapy as a necessary part of increased survival rates.	The analysis proved that ongoing beta-blocker treatment in the acute phase of severe sepsis patients decreased mortality rates up to 90 days.	Yes.
Goldstein (2019)	In the US, the number of patients with sepsis has soared during the last 20 years. It is questioned whether the resistance to antibiotics treatment affects the incidence of sepsis disease. Thus, it is vital to investigate the issue since there is almost no relevant data regarding the connection between uncured infections and sepsis disease.	A cohort study.	The independent variable is the incidence of sepsis due to the uncured diseases because of antibiotics resistance, and the dependent variable is the connection between the two and the influence of antibiotics resistance on sepsis mortality rates.	A study included patients with resistance to specific antibiotics among CAUTIs between 2011-2014. Patients were examined according to their age groups: 18-49, 50-64, 65-74, 75-84, 85+ years old. Moreover, the incidence of sepsis disease of those patients was analyzed along with the changes in mortality rates.	Nominal scale.	Among various bacteria and antibiotics combinations, the strongest association to the sepsis hospitalization was traced in patients of an age group of 50+ years old. However, the combinations considerably influenced sepsis mortality rates in patients of 18-84 years old.	It was concluded that the prevalence of antibiotics and bacteria resistance did not negatively influence the sepsis hospitalization and mortality rates. Furthermore, these positive findings prove the possibility of antibiotics replacement.	Yes.
Hatfield (2018)	The mortality rates of patients with severe sepsis or septic shock have been increased in the last years. It is questioned whether there is an association of individual and hospital factors with the fatal outcomes of sepsis.	A retrospective cohort study.	The independent variable is the septic shock or severe sepsis incidences, and the dependent variable is the influence of hospital and individual factors on mortality sepsis rated during 2013-2014.	A study included the hospitalizations from 3,068 care hospitals that took part in the Centers for Medicare and Medicaid Services. Overall, the analysis included 422320 patients with severe sepsis or septic shock. The association between hospitalization and sepsis mortality rates was investigated.	Nominal scale.	34.7% (146729 patients) out of analysis participants died from sepsis on or within a week of hospital discharge. Moreover, almost a third (27%) of patients acquired at least two infection types of disease during hospitalization.	It was concluded that sepsis mortality rates mainly depended on the disease measures on arrival. However, it was also claimed that the hospital factors considerably influenced the sepsis survival rates.	Yes.
Goodwin (2016)	The areas without accessible medical services are assumed to accommodate vulnerable to disease people. It was questioned whether the medically underserved territories influence the sepsis incidence and mortality rates.	A cohort study.	The independent variable is the septic shock or severe sepsis incidences, and the dependent variable is the influence of residential areas on changes in sepsis mortality rates.	A study included the analysis of administrative data regarding admission of sepsis to non-federal healthcare in North Carolina. It was determined whether patients live in medically or unmedically underserved areas from Department of Health and Human Services data. Further, the association of both residential classifications and sepsis mortality rates was compared.	Nominal scale.	Residents of the medically underserved area were admitted with severe sepsis more frequently (86 vs. 68 cases per 10000 people), and the odds of their death due to the disease were higher (15.5 deaths vs. 11.9 deaths per 10000 people).	It was concluded that residence in medically underserved areas considerably influences sepsis incidence and mortality rates of patients. Therefore, the higher sepsis incidence and decreased mortality rates were traced in patients of such territories.	Yes.

References

Fuchs, C., Wauschkuhn, S., Scheer, C., Vollmer, M., Meissner, K., Kuhn, S. O.,… & Rehberg, S. (2017). Continuing chronic beta-blockade in the acute phase of severe sepsis and septic shock is associated with decreased mortality rates up to 90 days. BJA: British Journal of Anaesthesia, 119(4), 616-625. Web.

Goldstein, E., MacFadden, D. R., Karaca, Z., Steiner, C. A., Viboud, C., & Lipsitch, M. (2019). Antimicrobial resistance prevalence, rates of hospitalization with septicemia and rates of mortality with sepsis in adults in different US states. International Journal of Antimicrobial Agents, 54(1), 23-34. Web.

Goodwin, A. J., Nadig, N. R., McElligott, J. T., Simpson, K. N., & Ford, D. W. (2016). Where you live matters: The impact of place of residence on severe sepsis incidence and mortality. Chest, 150(4), 829-836. Web.

Hatfield, K. M., Dantes, R. B., Baggs, J., Sapiano, M. R., Fiore, A. E., Jernigan, J. A., & Epstein, L. (2018). Assessing variability in hospital-level mortality among US medicare beneficiaries with hospitalizations for severe sepsis and septic shock. Critical Care Medicine, 46(11), 1753. Web.

Luhr, R., Cao, Y., Soederquist, B., & Cajander, S. (2019). Trends in sepsis mortality over time in randomized sepsis trials: A systematic literature review and meta-analysis of mortality in the control arm, 2002–2016. Critical Care, 23(1), 1-9. Web.

References

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