Another sort of goal-directed sepsis study, this time in Pediatrics at Primary Children’s. They implemented a protocolized triage system in their ED designed explicitly identify more cases of sepsis – which led to increased percentages getting early fluid resuscitation, early lactate level measurements, and more frequently antibiotics in the first three hours.
But the net effect of all these interventions…the only detectable difference in their 345 patient cohort was improved length-of-stay for survivors, from IQR 103-328 hours pre-intervention to IQR 86-214 post-intervention. Total hospital costs were not significantly different. No change in mortality – which was already low at 7%.
So, yet again – adherence to “quality measures” has debatable clinical significance.