SynthesisAnnals of internal medicine2025
The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review.
Synthesis in Annals of internal medicine, 2025. 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.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Diabetes mellitus and mortality in patients admitted to ICU with sepsis: a meta-analysis.Frontiers in medicine · 2026Pooled it
- Medical Record Abstraction for Quality Improvement in Sepsis Care Using Artificial Intelligence: A Cluster Randomized Trial.JAMA network open · 2026Trial
- Recent advances in screening, diagnosis, prognosis and personalized treatment of sepsis.European journal of microbiology & immunology · 2026Review
- Teaching to the Test: Threading the Needle on Sepsis Quality Metrics.Journal of general internal medicine · 2026Article
- A decade of SEP-1 compliance and sepsis mortality in the United States.Critical care (London, England) · 2026Article
- Integrating Precision Sepsis Risk Stratification Into Systems-Based Antimicrobial Stewardship.Open forum infectious diseases · 2026Article
- Challenges in early detection and prognostication of sepsis: new approaches from the emergency department and intensive care unit.EClinicalMedicine · 2026Review
- How large language models can help us write a systematic review.Intensive care medicine · 2026Article
- Implementation of a Sepsis Code Protocol at an Academic Institution in Colombia: A Pilot Study.Journal of clinical medicine · 2026Article
- Article
- Construction and validation of a nomogram based on clinical indicators for 28-day composite poor prognosis prediction in severe sepsis.Frontiers in public health · 2026Article
- Effects of meropenem plus ulinastatin on inflammatory response and complications in patients with severe septic shock.Frontiers in medicine · 2026Article
- Mortality and antibiotic timing in deep learning-derived surviving sepsis campaign risk groups: a multicenter study.Critical care (London, England) · 2025Observational
- ALA Alleviates Liver Damage in Septic Mice Through PI3K/AKT Signaling Pathway.Food science & nutrition · 2025Article
- Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26.Open medicine (Warsaw, Poland) · 2025Article
- Sesamoside Alleviates Inflammatory Response in Septic Shock-Associated Acute Liver Injury by Modulating the NF-κB/MAPK Signaling Pathway.Dose-response : a publication of International Hormesis SocietyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
backgroundThe Centers for Medicare & Medicaid Services (CMS) Severe Sepsis and Septic Shock Management Bundle (SEP-1) is now included in the Hospital Value-Based Purchasing (VBP) Program. PURPOSE: To assess the evidence supporting SEP-1 compliance or SEP-1 implementation in improving sepsis mortality. DATA SOURCES: PubMed, Web of Science, EMBASE, CINAHL Complete, and Cochrane Library from inception to 26 November 2024. STUDY SELECTION: Studies of adults with sepsis that included 3- or 6-hour sepsis bundles defined by SEP-1 specifications. DATA EXTRACTION: Article screening, full-text review, data extraction, and risk-of-bias assessment were independently performed by 2 authors. Level of evidence was determined using GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria and National Quality Forum criteria. DATA SYNTHESIS: A total of 4403 unique references were screened, and 17 studies were included. Twelve studies assessed the relationship between SEP-1 compliance and mortality; 5 showed statistically significant benefit, whereas 7 did not. Among studies showing benefit, 1 did not adjust for confounders, 1 found benefit only among patients with severe sepsis, 1 included only patients with septic shock, and 1 included only Medicare beneficiaries. Five studies assessed the relationship between SEP-1 implementation and sepsis mortality; only 1 showed significant benefit, but it did not adjust for mortality trends before SEP-1 implementation. All 17 studies were observational, and none had low risk of bias. LIMITATIONS: The conclusions are limited by the underlying quality of the available studies, as all were observational. Because there was considerable methodologic heterogeneity among the included studies, a meta-analysis was not performed as the results could have been misleading.
conclusionThis review found no moderate- or high-level evidence to support that compliance with or implementation of SEP-1 was associated with sepsis mortality. CMS should reconsider the addition of SEP-1 to the Hospital VBP Program. PRIMARY FUNDING SOURCE: None. (PROSPERO: CRD42023482787).
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