ArticleCritical care (London, England)2023
Time to treatment and mortality for clinical sepsis subtypes.
Article in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Timing of antibiotic initiation in sepsis and neutropenic fever.Frontiers in medicine · 2025Pooled it
- Dual-function oral nanotherapeutic mitigates sepsis-like multi-organ failure by targeting inflammatory and fibrotic pathways.Bioactive materials · 2026Article
- Prehospital lactate, transfer time, and early mortality across emergency diagnostic categories.Critical care (London, England) · 2026Observational
- SERS-Based Universal AST: Rapid Treatment Guidance for Blood-Culture Bacteria before Species Identification.Analytical chemistry · 2026Article
- Effect of norepinephrine initiation timing on mortality in septic shock: a multicenter cohort study.BMC anesthesiology · 2026Observational
- Timing of Core Sepsis Bundle Elements Initiation in Critically Ill Patients: A Multicenter Target Trial Emulation Study.Clinical epidemiology · 2026Article
- A single-center study on epidemiology, microbial distribution, and mortality predictors in catheter-related bloodstream infections.BMC infectious diseases · 2025Article
- [Specialty-specific knowledge as prerequisite for effective treatment of critically ill patients].Chirurgie (Heidelberg, Germany) · 2025Article
- OPTIMAL PAO 2 IS 130-160 MMHG IN THE FIRST WEEK FOR SEPSIS PATIENTS IN ICU: A RETROSPECTIVE COHORT STUDY BASED ON MIMIC-IV DATABASE.Shock (Augusta, Ga.) · 2025Article
- IL-10 to lymphocyte ratio (ILR) and lactate in the prognosis prediction and risk stratification of sepsis: a pilot study.Frontiers in medicine · 2025Article
- Diagnostic utility of IL-18 plasma levels in distinguishing abdominal from non-abdominal sepsis.Frontiers in immunology · 2025Article
- Article
- High mortality associated with inappropriate initial antibiotic therapy in hematological malignancies with Klebsiella pneumoniae bloodstream infections.Scientific reports · 2024Article
- Heterogeneity of Benefit from Earlier Time-to-Antibiotics for Sepsis.American journal of respiratory and critical care medicine · 2024Observational
- Predictive Value of Combined Detection of Serum LGALS3BP and GDF-15 for the Prognosis of ICU Sepsis Patients.Infection and drug resistance · 2024Article
- Artificial intelligence-assisted phenotyping of sepsis: Research progress, clinical challenges, and translational prospects.Digital healthReview
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Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundSepsis is common, deadly, and heterogenous. Prior analyses of patients with sepsis and septic shock in New York State showed a risk-adjusted association between more rapid antibiotic administration and bundled care completion, but not an intravenous fluid bolus, with reduced in-hospital mortality. However, it is unknown if clinically identifiable sepsis subtypes modify these associations.
methodsSecondary analysis of patients with sepsis and septic shock enrolled in the New York State Department of Health cohort from January 1, 2015 to December 31, 2016. Patients were classified as clinical sepsis subtypes (α, β, γ, δ-types) using the Sepsis ENdotyping in Emergency CAre (SENECA) approach. Exposure variables included time to 3-h sepsis bundle completion, antibiotic administration, and intravenous fluid bolus completion. Then logistic regression models evaluated the interaction between exposures, clinical sepsis subtypes, and in-hospital mortality.
results55,169 hospitalizations from 155 hospitals were included (34% α, 30% β, 19% γ, 17% δ). The α-subtype had the lowest (N = 1,905, 10%) and δ-subtype had the highest (N = 3,776, 41%) in-hospital mortality. Each hour to completion of the 3-h bundle (aOR, 1.04 [95%CI, 1.02-1.05]) and antibiotic initiation (aOR, 1.03 [95%CI, 1.02-1.04]) was associated with increased risk-adjusted in-hospital mortality. The association differed across subtypes (p-interactions < 0.05). For example, the outcome association for the time to completion of the 3-h bundle was greater in the δ-subtype (aOR, 1.07 [95%CI, 1.05-1.10]) compared to α-subtype (aOR, 1.02 [95%CI, 0.99-1.04]). Time to intravenous fluid bolus completion was not associated with risk-adjusted in-hospital mortality (aOR, 0.99 [95%CI, 0.97-1.01]) and did not differ among subtypes (p-interaction = 0.41).
conclusionTimely completion of a 3-h sepsis bundle and antibiotic initiation was associated with reduced risk-adjusted in-hospital mortality, an association modified by clinically identifiable sepsis subtype.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.