| van Zanten et al. (2014) [43] | To evaluate the effect of implementation of SSC bundles on adherence to the 6- and 24-hour sepsis bundle targets and adjusted in-hospital mortality. | Quasi-experimental, prospective, multicenter cohort in participating and nonparticipating centers. | 82 ICUs in the Netherlands. | N = 16,418 Convenient | 2009-2013 | Adherence to sepsis bundles was associated with reduced adjusted in-hospital mortality only in participating ICUs, adjusted OR per month = 0.992 [0.986 - 0.997]) equivalent to 5.8% adjusted absolute mortality reduction over 3.5 years. A relative in-hospital mortality reduced by 16.7% over 3.5 years among patients in the ICUs. |
| Uvizl et al. (2016) [44] | To analyze the relationship between in-hospital mortality (either in ICU or after discharge from ICU) and the type and number of fulfilled diagnostic and treatment interventions during the first 6 hours after the diagnosis of severe sepsis/septic shock. | Multicenter, retrospective, observational study, which included all consecutive patients aged 18 and over who were admitted to participating ICUs from 1 January 2011 to 5 November 2013. | 17 ICUs with a total of 220 beds in 12 hospitals in the Czech Republic. | N = 1082 Consecutive | 2011-2013 | The most effective measures associated with the lowest in-hospital mortality in patients with septic shock were CVP of ≥8 - 12 mm Hg, MAP of ≥65 mm Hg, urine output at ≥0.5 mL/kg/h, initial lactate level of ≤4.0 mmol/L and administration of antibiotics within the first hour. |
| Ferrer et al. (2009) [45] | To analyze the impact of treatments for severe sepsis on hospital mortality in all patients included in the three periods of the study (pre-educational period, post-educational period, and long-term follow-up). | Prospective, observational descriptive study that included three inclusion periods: a 2-month period before the implementation of an educational program, a 4-month period after its implementation, and a 2-month, long-term follow-up for 1 year. | 77 ICUs in Spain. | N = 2804 Convenient | 2006-2007 | Early administration of broad-spectrum antibiotics in all patients reduce mortality. |