title: Computerized clinical decision support improves mortality in intra abdominal surgical sepsis.
abstract: BACKGROUND
  The management of surgical sepsis is challenging because of the complexity of interventions. The authors therefore created a computerized clinical decision support program to facilitate this process, with the goal of improving abdominal sepsis mortality.
  
  
  METHODS
  The authors evaluated a prospective database for all patients requiring surgery for abdominal sepsis. Patient demographics, Acute Physiology and Chronic Health Evaluation II score, sepsis source, and hospital mortality data were obtained. Observed mortality was compared with predicted mortality using Fisher's exact test.
  
  
  RESULTS
  Eighty-seven patients met the inclusion criteria. The average age was 59 ± 17.0 years, and 39% were men. The most common source of infection was the colon (45%). The average Acute Physiology and Chronic Health Evaluation II score was 27.6 ± 9.72. The overall actual mortality rate for the cohort was 24% compared with a predicted Acute Physiology and Chronic Health Evaluation II mortality of 62.5% (P < .0001).
  
  
  CONCLUSIONS
  The use of computerized clinical decision support results in significantly improved survival in patients with intra-abdominal surgical sepsis.
authors.affiliation: Weill Cornell Medical College, Surgical Critical Care and Acute Care Surgery, Department of Surgery, Houston, TX, USA. ljmoore@tmhs.org
authors.forename: Laura Jane
authors.initials: LJ
authors.lastname: Moore
authors.forename: Krista L
authors.initials: KL
authors.lastname: Turner
authors.forename: Samual R
authors.initials: SR
authors.lastname: Todd
authors.forename: Bruce
authors.initials: B
authors.lastname: McKinley
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Moore
mesh_terms: D018806:APACHE; D000005:Abdomen / Q000601:surgery; D003658:Decision Making, Computer-Assisted; D019317:Evidence-Based Medicine; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality* / Q000601:surgery; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology / Q000401:mortality