N/A
N=3,230
Effect of Emergency Department Care Reorganization on Door-to-antibiotic Times for Sepsis (LDS SWARM)
Septic Shock · Sepsis
Bottom Line
View on ClinicalTrials.gov: NCT03226366 ↗Enrolled (actual)
3,230
Serious AEs
0.0%
Results posted
Jun 2020
Primary outcome: Primary: Time From ED Arrival to Administration of First Dose of Antibiotics — 173; 165; 169; 163 minutes — p=0.29
Study Design & Population
- Study type
- Observational
- Phase
- N/A
- Interventions
- Immediate evaluation by multidisciplinary team (Other)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Intermountain Health Care, Inc.
- Primary completion
- Jan 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Time From ED Arrival to Administration of First Dose of Antibiotics |
173; 165; 169; 163 | 0.29 |
| SECONDARY Hospital Mortality |
19; 7; 23; 11 | 0.72 |
| SECONDARY ED Length of Stay |
280; 265; 269; 261 | 0.26 |
| SECONDARY Door-to-physician Evaluation Time |
25; 23; 22; 20 | 0.55 |
Summary
Sepsis is a common syndrome resulting from a dysregulated response to infection. The timing of antibiotic initiation is an important determinant of outcomes for patients presenting to the emergency department with sepsis. The potential effect of care reorganization on very early care for sepsis is unknown. This study will investigate whether multidisciplinary coordination of the initial patient evaluation in the emergency department influences door-to-antibiotic time for septic patients.
Eligibility Criteria
Primary inclusion criteria:
- Adult patients age ≥18 years
- Presented to the ED of study hospital from May 16, 2015 to April 15, 2016 (pre-implementation cohort) or May 16 to November 15, 2016 (post-implementation cohort)
- Sepsis present in ED (Sequential Organ Failure Assessment [SOFA] score ≥2 points above baseline while in ED plus antibiotic initiation while in the ED)
- Triage acuity score 2-5
Inclusion criteria for supplemental sensitivity analyses:
- Presented to the ED of study hospital between May 16, 2015 and April 15, 2016 (pre-implementation cohort) or May 16, 2016 and February 15, 2017 (post-implementation cohort).
- Sepsis on presentation to ED, defined as initial Sequential Organ Failure Assessment (SOFA) score ≥2 points above baseline plus antibiotics initiation within 24 hours of ED arrival.
Overall exclusion criteria:
- Age <18 years
- No antibiotics within 24 hours of ED arrival
Data sourced from ClinicalTrials.gov (NCT03226366). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.