Table 2

Patient demographics and clinical impact of implementation of whole of hospital sepsis pathway

Historical cohort
(April–December 2012)
Post-implementation cohort
(April–December 2013)
Year 2 of pathway
(January–December 2014)
On pathwayNot on pathwayOn pathwayNot on pathway
Admitted patient group, n (%)111 (100%)176 (100%)36 (100%)322 (100%)127 (100%)
Haematology, n (%)57 (51.4)87 (49.3)17 (47.2)148 (48.0)34 (26.8)
Medical oncology, n (%)27 (24.2)40 (22.7)8 (22.2)75 (23.3)37 (29.1)
Radiation oncology, n (%)14 (12.6)9 (5.1)7 (19.4)32 (9.9)13 (10.2)
Surgical oncology, n (%)13 (11.7)40 (22.7)*4 (11.1)67 (20.8)43 (33.9)
Age (median, range)60 (22–88)63 (18–87)66 (20–88)63 (49–70)65.4 (55–74.5)
Male, n (%)67 (60.4)101 (57.4)23 (63.9)184 (54.1%)85 (66.9%)
Hypotensive<100 mm Hg, n (%)19 (17)31 (18)7 (19)28 (8.7)11 (8.7)
Heart rate, mean (SD)118 (21.2)120 (22.9)108 (19.2)103 (18.1)101 (19.7)
Respiratory rate, mean (SD)22.6 (19.3)21.1 (4.6)21.6 (4.7)19.9 (5.9)20.5 (4.5)
Temperature (°C), mean (SD)38.2 (0.8)38.3 (0.8)37.9 (1.0)38.1 (1.8)38.1 (1.1)
Median white cell count (range)3 (0–30)3 (0–41)4 (0–60)4.3 (0.02–114)9.4 (0.02–116)
Neutropaenia, n (%)47 (43.1)71 (40.3)13 (36.1)123 (38.2)23 (18.1)
Surgery last 30 days, n (%)7 (6.3)32 (18.3)*6 (16.7)51 (15.9)42 (33.1)
Two sets of BC prior to antibiotics, n (%)56 (50.4)131 (74.4)†23 (63.9)200 (62.1)†26 (28.4)
Lactate level done, n (%)19 (17.2)132 (75.0)*21 (58.3)243 (75.5)56 (44.1)
Lactate level ≥4, n (%)2/19 (10.5)3/132 (2.2)3/21 (14.2)7/243 (2.9)5/56 (8.9)
Rapid fluid bolus if SBP<100 mm Hg12/19 (63.2)22/31 (70.9)5/7 (71.4)11/28 (39.3)2/11 (18.2)
Mean fluid bolus volume (mL)423512542642400
Median time to antibiotics, min (range)110 (0–3010)55 (0–660)*60 (0–405)60.5 (5–1400)175 (10–1245)
Appropriate‡ first antibiotic, n (%)85 (76.1)156 (88.4)*/†27 (75.0)306 (95)96 (75.6)
Bacteraemia, n (%)56 (50.5)52 (29.1)16 (44.4)63 (19.6)21 (16.5)
Appropriate initial antibiotic for BC45/56 (80.4)47/52 (90.4)14/16 (87.5)60/63 (95.3)18/21 (85.7)
ICU admission, n (%)39 (35.5)30 (17.1)*11 (30.6)59 (18.3)37 (29.1)
Inotropes required, n (%)30 (29.1)14 (8.3)*5 (13.9)29 (9.01)23 (18.1)
Ventilation required, n (%)10 (9.0)6 (3.4)3 (8.3)14 (4.35)20 (15.8)
ICU LOS, mean (SD)4.9 (6.9)2.8 (1.9)*6.6 (7.1)3.0 (1–25)3 (1–29)
Hospital LOS after sepsis onset (days, median, range)9.9 (0.5–164.5)7.5 (10.9–75.7)7.8 (2.3–68.6)9 (2–112)11 (2–94)
Died due to sepsis18 (16.2)9 (5.0)*4 (11.1)25 (7.7)12 (9.4)
30-Day all-cause mortality, n (%)21 (18.9)13 (7.4)*6 (16.7)26 (8.1)18 (14.2)
  • *P<0.05 comparing historical and pathway cohort.

  • †P<0.05 comparing pathway cohorts from postimplementation and year 2.

  • ‡There were only three cases with a multidrug-resistant Gram-negative pathogen and three cases with multidrug-resistant Gram-positive pathogens for which the initial antibiotic therapy did not cover the pathogen.

  • BC, blood culture; ICU, intensive care unit; LOS, length of stay; SBP, systolic blood pressure.