Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey

<b>Rationale:</b> Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. <b>Objectives:</b> To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. <b>Methods:</b> A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. <b>Measurements and Main Results:</b> A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. <b>Conclusions:</b> The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.

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Publication Details

Journal
American Journal of Respiratory and Critical Care Medicine
Published
2025-01-09
DOI
https://doi.org/10.1164/rccm.202406-1167oc
Citations
9
Primary Topic
Sepsis Diagnosis and Treatment
Type
article
Field-Weighted Citation Impact
12.19

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article

Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey

Gabriella Bottari, Djillali Annane, Johanna Hästbacka, Ken Dewitte et al.
9 citations
American Journal of Respiratory and Critical Care Medicine
Sepsis Diagnosis and Treatment
12.19
article

Status of Sepsis Care in European Hospitals: Results from an International Cross-Sectional Survey

Gabriella Bottari, Djillali Annane, Johanna Hästbacka, Ken Dewitte, Evangelos J. Giamarellos‐Bourboulis, José Artur Paiva, Gianpaola Monti, Antonio Artigas, Marcus Vollmer, Annmarie Touborg Lassen, Miltiades Kyprianou, Renata Curić Radivojević, К. М. Лебединский, Jan Máca, Manu L. N. G. Malbrain, Mohan Gurjar, Natalija Vuković, Mohamed Elbahnasawy, Mihai Gabriel Ştefan, Matthias Gründling, Adam Linder, Christian Scheer, Marlies Ostermann, Konrad Reinhart, Michael Osthoff, Hjalmar R. Bouma, Jakub Śmiechowicz, Michela Sabbatucci, Konstantina Dakou, Kyriakos Zaragkoulias, Vladimír Černý, Abdullah Tarık Aslan, Ricard Ferrer, Evgeny A. Idelevich, Daniela Filipescu, Said Laribi
article en
9 citations

Abstract

<b>Rationale:</b> Early detection, standardized therapy, adequate infrastructure, and strategies for quality improvement should constitute essential components of every hospital's sepsis plan. <b>Objectives:</b> To investigate the extent to which recommendations from the sepsis guidelines are implemented and the availability of infrastructure for the care of patients with sepsis in acute-care hospitals. <b>Methods:</b> A multidisciplinary cross-sectional questionnaire was used to investigate sepsis care in hospitals. This included the use of sepsis definitions, the implementation of sepsis guideline recommendations, diagnostic and therapeutic infrastructure, antibiotic stewardship, and quality improvement initiatives (QIIs) in hospitals. <b>Measurements and Main Results:</b> A total of 1,023 hospitals in 69 countries were included. Most of them, 835 (81.6%), were in Europe. Sepsis screening was used in 54.2% of emergency departments (EDs), 47.9% of wards, and 61.7% of ICUs. Sepsis management was standardized in 57.3% of EDs, 45.2% of wards, and 70.7% of ICUs. The implementation of comprehensive QIIs was associated with increased screening (EDs, +33.3%; wards, +44.4%; ICUs, +23.8% absolute difference) and increased standardized sepsis management (EDs, +33.6%; wards, +40.0%; ICUs, +17.7% absolute difference) compared with hospitals without QIIs. A total of 9.8% of hospitals had implemented ongoing QIIs, and 4.6% had invested in sepsis programs. <b>Conclusions:</b> The findings indicate that there is considerable room for improvement in a large number of mainly European hospitals, particularly with regard to early identification and standardized management of sepsis, the availability of guidelines, diagnostic and therapeutic infrastructure, and the implementation of QIIs. Further efforts are required to implement a more comprehensive and appropriate quality of care.

American Journal of Respiratory and Critical Care MedicineVol. 211(4)
Université de Tours (FR), Medical University of Lublin (PL), Hebron University (PS), Friedrich-Loeffler-Institut (DE), St Thomas' Hospital (GB), University Medical Center Groningen (NL), University of Helsinki (FI), University Hospital Centre Zagreb (HR), University of Nis (RS), Sanjay Gandhi Post Graduate Institute of Medical Sciences (IN), Carol Davila University of Medicine and Pharmacy (RO), University of Ostrava (CZ), Lund University (SE), Université de Versailles Saint-Quentin-en-Yvelines (FR), National and Kapodistrian University of Athens (GR), Charles University (CZ), Tanta University (EG), Universitätsmedizin Greifswald (DE), Levanger Hospital (NO), Helsinki University Hospital (FI), Odense University Hospital (DK), University Hospital of Basel (CH), Hospital de São João (PT), Constantine the Philosopher University in Nitra (SK), Universität Greifswald (DE), Wroclaw Medical University (PL), Tanta University Hospital (EG), Institutul de Urgenţă pentru Boli Cardiovasculare "Prof.Dr. C.C. Iliescu" (RO), University Hospital Ostrava (CZ), Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda (IT), Centre Hospitalier Universitaire de Tours (FR), Assistance Publique – Hôpitaux de Paris (FR), Antwerp University Hospital (BE), Vall d'Hebron Institut de Recerca (ES), University Hospital Münster (DE), St Olav's University Hospital (NO), National Institute of Health (AM), Bambino Gesù Children's Hospital (IT), Hospital de Sabadell (ES), Tampere University Hospital (FI), Department of Biomedicine Basel (CH), Tampere University (FI), Hôpital Raymond-Poincaré (FR), Institute of Research and Innovation Parc Tauli (ES), North-Western State Medical University named after I.I. Mechnikov (RU), Prolepsis Institute (GR), Data Management (Italy) (IT), Hacettepe University (TR), Charité - Universitätsmedizin Berlin (DE)
Intensive Care Society, European Society of Clinical Microbiology and Infectious Diseases, European Society of Anaesthesiology, European Society of Intensive Care Medicine
Openalex Percentile: Top 1%
Sepsis Diagnosis and Treatment
12.19
DOIOpen Access PDFOpenAlex
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