News: Delaying sepsis antibiotics in the ED increases odds of mortality

In the ED setting, timely administration of antibiotics to patients with clinical sepsis saves lives, according to recent research published in CHEST. In fact, the researchers associated each additional hour from ED arrival to antibiotic administration with 10% increased odds of one-year mortality, HealthLeaders Media reported.

The research is based on data collected from nearly 11,000 patients, who experienced a 19% one-year mortality rate. The median door-to-antibiotic time in the study was 166 minutes. Each additional hour between arrival and antibiotic administration was also associated in rises in 30-day readmissions and 30-day mortality.

“Our research adds to the evidence that every hour matters when it comes to initiation of appropriate antibiotics for sepsis, impacting not just short-term but also long-term mortality,” Ithan Peltan, MD, MSc, an attending physician at in the Department of Medicine at Intermountain Medical Center in Murray, Utah, and the lead study author, told HealthLeaders Media. “The fact that the association was fairly linear suggests there is no acceptable window of delay.”

This new study also brings credence to many CDI professionals’ concerns over the use of sepsis-3 criteria, which requires the presence of life-threatening organ dysfunction. Under other criteria sets (and according to CMS), this condition would be classified as severe sepsis.

Critics of sepsis-3 adoption have pointed out that the criteria would lead to slower interventions since the patient’s clinical picture would have to deteriorate to the level of organ dysfunction before they would be classified as septic. According to a February 2018 ACDIS poll, only 16% of respondents’ facilities use sepsis-3 criteria, versus 60% that use sepsis-2. This new study in CHEST indicates that waiting even an hour for your patient to meet sepsis-3 criteria may significantly affect their chances of mortality for the worse.

Editor’s note: To read HealthLeaders Media’s coverage of the new research in CHEST, click here. To read the study itself, click here. To learn more about sepsis-3 criteria, click here.