The PROCESS and SEPSISPAM studies were serious blows to protocol EGD therapy in sepsis. With all the other dead ends we pursued (activated protein C, colloids, intensive insulin therapy, cortisone and what not) it is tempting to think that little progress has been made. That is not the case. Many studies demonstrate decreasing mortality from sepsis in the last decade. Now, in JAMA, a massive Australian-New Zealandite (sic?) database study confirms we are doing something right.
Retrospective study that included all severe sepsis patients from 2000 to 2012. A total of 101604 patients were identified making up 9,7% of the total ICU populations from 171 ICUs during the time period.
Mortality in the subgroup with septic shock mortality decreased from 40,3% to 22%.
Take home message:
We are doing something right. Increased awareness, earlier antibiotics, appropriate antibiotics, improved diagnostic procedures and aggressive supportive treatment probably all contributed to this.
Study lives here:
Mortality related to severe sepsis and septic shock among critically ill patients in Australia and New Zealand, 2000-2012. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R. JAMA. 2014 Apr 2;311(13):1308-16. doi: 10.1001/jama.2014.2637.