title: Sepsis resuscitation guideline implementation in the Department of Emergency Medicine, Siriraj Hospital.
abstract: BACKGROUND
  Sepsis management guidelines have been implemented in the Emergency Department, Siriraj Hospital since 2005.
  
  
  OBJECTIVE
  Assess the impact ofsepsis resuscitation guidelines on the mortality ofpatients after implementation.
  
  
  METHODS
  A prospective cohort study was conducted in the Emergency Department, Siriraj Hospital between January 12 and October 2, 2011. Patients aged older than 18 years old were included The baseline data and the extent of goal achievement were recorded The primary outcome was the 30-day mortality rate.
  
  
  RESULTS
  One hundredfortyfour patients (34% severe sepsis, 66% septic shock) were included The overall 30-day mortality was 39.6%. Antibiotics were administered within I hour in 52.2% of the patients. At least I or at least 2 therapeutic goals were accomplished in 86.8% and 50.7% of patients, respectively, and the achievement of at least 2 goals was associated with lower mortality (adjusted OR 0.41, 95% CI 0.19-0.89). Two patients (1.4%) completely achieved goals within 6 hours. Respiratory failure requiring endotracheal tube insertion was associated with higher mortality (adjusted OR 3.12, 95% CI 1.32-7.38).
  
  
  CONCLUSIONS
  The 30-day mortality was 39.6%. The achievement of at least 2 goals was associated with lower mortality. Endotracheal tube insertion was associated with higher mortality.
authors: Tanyaporn
authors: T
authors: Nakornchai
authors: Usapan
authors: U
authors: Surabenjawong
authors: Apichaya
authors: A
authors: Monsomboon
authors: Nattakam
authors: N
authors: Praphruetkit
authors: Tipa
authors: T
authors: Chakorn
mesh_terms: D000368:Aged; D015331:Cohort Studies; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D019983:Guideline Adherence; D017052:Hospital Mortality; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012151:Resuscitation / Q000592:standards*; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D013785:Thailand