Clin Exp Emerg Med.
2017 Sep;4(3):146-153. 10.15441/ceem.17.204.
Korean Shock Society septic shock registry: a preliminary report
- Affiliations
-
- 1Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 2Department of Emergency Medicine, Hallym University College of Medicine, Seoul, Korea.
- 3Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 4Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
- 5Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea.
- 6Department of Emergency Medicine, Guro Hospital, Korea University Medical Center, Seoul, Korea.
- 7Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. suhgil@snu.ac.kr
- 8Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea.
- 9Department of Emergency Medicine, Korea University Anam Hospital, Seoul, Korea.
- 10Department of Emergency Medicine, Kyung Hee University Hospital, Seoul, Korea.
- KMID: 2401243
- DOI: http://doi.org/10.15441/ceem.17.204
Abstract
OBJECTIVE
To evaluate the clinical characteristics, therapeutic interventions, and outcomes of patients with septic shock admitted to the emergency department (ED).
METHODS
This study was a preliminary, descriptive analysis of a prospective, multi-center, observational registry of the EDs of 10 hospitals participating in the Korean Shock Society. Patients aged 19 years or older who had a suspected or confirmed infection and evidence of refractory hypotension or hypoperfusion were included.
RESULTS
A total of 468 patients were enrolled (median age, 71.3 years; male, 55.1%; refractory hypotension, 82.9%; hyperlactatemia without hypotension, 17.1%). Respiratory infection was the most common source of infection (31.0%). The median Sepsis-related Organ Failure Assessment score was 7.5. The sepsis bundle compliance was 91.2% for lactate measurement, 70.3% for blood culture, 68.4% for antibiotic administration, 80.3% for fluid resuscitation, 97.8% for vasopressor application, 68.0% for central venous pressure measurement, 22.0% for central venous oxygen saturation measurement, and 59.2% for repeated lactate measurement. Among patients who underwent interventions for source control (n=117, 25.1%), 43 (36.8%) received interventions within 12 hours of ED arrival. The in-hospital, 28-day, and 90-day mortality rates were 22.9%, 21.8%, and 27.1%, respectively. The median ED and hospital lengths of stay were 6.8 hours and 12 days, respectively.
CONCLUSION
This preliminary report revealed a mortality of over 20% in patients with septic shock, which suggests that there are areas for improvement in terms of the quality of initial resuscitation and outcomes of septic shock patients in the ED.
