Miller III et al. (2013) [40] | To assess the effect on mortality of compliance with a severe sepsis and septic shock management guidelines. | An observational, retrospective, descriptive design was used. The study was conducted over three stages based on ICU admission date: (1) baseline and bundle development stage, (2) implementation stage, and (3) tracking stage. | 18 ICUs in 11 hospitals in Utah and Idaho in the USA. | N = 4329 convenient | 2004 and 2010 | Severe sepsis and septic shock guidelines were associated with a marked reduction in hospital mortality after adjustment for age, severity of illness, and comorbidities. Relative mortality declined 59.0% from 21.2% at baseline to 8.7% for 2010 (p < 0.0001). |
Sánchez et al. (2017) [41] | To analyze the evolution of sepsis-related mortality in Spanish ICUs following the introduction of the SSC guidelines and the relationship with sepsis process-of-care. | Quasi-experimental prospective cohort design was used. The study was conducted during two time periods: 2005 (Edusepsis study pre-intervention group) and 2011 (ABISS-Edusepsis study pre-intervention group). | 41 medical-surgical ICUs in tertiary hospitals in Spain. | N = 1348 Consecutive | 2005 to 2011 | Patients in the interventional group had lower hospital mortality (32.6% vs. 44.0%; p < 0.001), lower 28-day mortality (23.0% vs. 36.5%; p < 0.001), and lower adjusted mortality (OR 0.64 [0.49 - 0.83], p = 0.001). |
Thompson et al. (2016) [42] | To explore how the level of resuscitation guidelines adherence inhospitals influenced changes in outcomes of patients with sepsis and septic shock. | A quasi-experimental study compared patients with sepsis and septic shock in collaborative hospitals to other groups of patients in noncollaborative hospitals using the Michigan Inpatient Database. | 87 Michigan hospitals with ICUs in the USA. | N = 48,110 Convenient | 2012-2013 | High adherence hospitals had significantly reduced in-hospital mortality between pre- and post-periods (35.0% vs 29.7%; p < 0.001), compared to non-collaborative hospitals. High adherence hospitals had significant reductions in mortality (OR, 0.84; 95% CI, 0.79 - 0.93; p < 0.001). |