Observational studyPloS one2022
Hour-1 bundle adherence was associated with reduction of in-hospital mortality among patients with sepsis in Japan.
Observational study in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 27 citations in OpenAlex.
- Hour-1 Sepsis Bundle: Updated Evidence.Journal of clinical medicine · 2026Review
- Completion of the 1-Hour Sepsis Bundle on 90-Day Mortality in Adult Patients With Sepsis.Journal of the American College of Emergency Physicians open · 2026Article
- An artificial intelligence-powered learning health system to improve sepsis detection and quality of care: a before-and-after study.NPJ digital medicine · 2026Article
- Impact of concordant ICU triage on hospital mortality: a nationwide retrospective multilevel analysis.Frontiers in medicine · 2026Article
- Nationwide survey of adherence to the Japanese Clinical Practice Guidelines for Management of Sepsis and Septic Shock 2024 in the initial management of sepsis.Journal of intensive care · 2025Article
- Article
- Influence of underlying condition and performance of sepsis bundle in very old patients with sepsis: a nationwide cohort study.Annals of intensive care · 2024Article
- Challenges of implementing the hour-1 sepsis bundle: a qualitative study from a secondary hospital in Indonesia.Acute and critical care · 2024Article
- Rapid and Robust Identification of Sepsis Using SeptiCyte RAPID in a Heterogeneous Patient Population.Journal of clinical medicine · 2024Article
- Machine learning-based prognostic model for 30-day mortality prediction in Sepsis-3.BMC medical informatics and decision making · 2024Article
- Article
- Article
- Risk of Misleading Conclusions in Observational Studies of Time-to-Antibiotics and Mortality in Suspected Sepsis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- The reverse shock index multiplied by the Glasgow Coma Scale score can predict the need for initial resuscitation in patients suspected of sepsis.Global health & medicine · 2023Article
- Effect of a quality improvement program on compliance to the sepsis bundle in non-ICU patients: a multicenter prospective before and after cohort study.Frontiers in medicine · 2023Article
- Relationship Between the Use of Preprinted Physician Orders for Hospital-Acquired Fever and Time to Blood Culture Collection: A Single-Center Retrospective Cross-Sectional Study.International journal of general medicine · 2022Article
Corrections and comments
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Authors and funding
28 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe updated Surviving Sepsis Campaign guidelines recommend a 1-hour window for completion of a sepsis care bundle; however, the effectiveness of the hour-1 bundle has not been fully evaluated. The present study aimed to evaluate the impact of hour-1 bundle completion on clinical outcomes in sepsis patients.
methodsThis was a multicenter, prospective, observational study conducted in 17 intensive care units in tertiary hospitals in Japan. We included all adult patients who were diagnosed as having sepsis by Sepsis-3 and admitted to intensive care units from July 2019 to August 2020. Impacts of hour-1 bundle adherence and delay of adherence on risk-adjusted in-hospital mortality were estimated by multivariable logistic regression analyses.
resultsThe final study cohort included 178 patients with sepsis. Among them, 89 received bundle-adherent care. Completion rates of each component (measure lactate level, obtain blood cultures, administer broad-spectrum antibiotics, administer crystalloid, apply vasopressors) within 1 hour were 98.9%, 86.2%, 51.1%, 94.9%, and 69.1%, respectively. Completion rate of all components within 1 hour was 50%. In-hospital mortality was 18.0% in the patients with and 30.3% in the patients without bundle-adherent care (p = 0.054). The adjusted odds ratio of non-bundle-adherent versus bundle-adherent care for in-hospital mortality was 2.32 (95% CI 1.09-4.95) using propensity scoring. Non-adherence to obtaining blood cultures and administering broad-spectrum antibiotics within 1 hour was related to in-hospital mortality (2.65 [95% CI 1.25-5.62] and 4.81 [95% CI 1.38-16.72], respectively). The adjusted odds ratio for 1-hour delay in achieving hour-1 bundle components for in-hospital mortality was 1.28 (95% CI 1.04-1.57) by logistic regression analysis.
conclusionCompletion of the hour-1 bundle was associated with lower in-hospital mortality. Obtaining blood cultures and administering antibiotics within 1 hour may have been the components most contributing to decreased in-hospital mortality.
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