there was complete compliance with the 6-hour bundle (OR 0.54; CI 95% 0.30 - 0.96, p = 0.033) and when there was complete compliance with all of the components of the 24-hour bundle (OR 0.37; CI 95% 0.24 - 0.58, p < 0.001).

Cardoso et al. (2010) [35]

To evaluate the impact of compliance with a core version of the SSC 6-hour

bundle on 28-day mortality.

Descriptive Cohort, multi-center, prospective study was conducted over one year. Patients were followed up until death or hospital discharge.

17 ICUs in Portugal.

N = 778

Consecutive

2004 to 2005

Compliance with all actions 1 to 6 was associated with an OR of 0.44 [95% CI = 0.24 - 0.80] in severe sepsis and 0.49 (95% CI = 0.25 - 0.95) in septic shock, for 28-days mortality. Collecting blood cultures and giving vasopressors were significantly protective.

Herrán-Monge et al. (2017) [36]

To determine the epidemiology and outcome of severe sepsis and septic shock after 9 years of the implementation of the SSC guidelines, and to build a mortality prediction model.

Quasi-experimental,

Prospective, multicenter

study was performed during a 5-month. Findings were compared with those obtained in the same ICUs in a study conducted in 2002.

11 medical/ surgical ICUs in 10 teaching hospitals in Spain.

N = 262

Convenient

2011

The 2011 cohort had a marked reduction in 48-hour (7% vs 14.8%), ICU (27.2% vs 48.2%), and in-hospital (36.7% vs 54.3%) mortalities.

The implementation of the SSC guidelines resulted in a marked decrease in the overall mortality.