Evidence map›Paper›PMID 40394519›Full record

ArticleBMC infectious diseases2025

The association of sepsis bundle compliance with mortality in patients with ICU-acquired sepsis: a cohort study.

Adam Green, Sharad Patel, Pamela Crabtree, Divyesha Patel, Andrew Hoke, Ricardo Jaime Orozco, George Sangah, Alvin Mercado, Nicole Melchiorre, Mariane Charron and 2 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Adam GreenDepartment of Critical Care Medicine, Cooper University Health Care and Cooper Medical School of Rowan University, 1 Cooper Plaza D429, Camden, NJ, 08103, USA. Green-adam@cooperhealth.edu.
Sharad PatelDepartment of Critical Care Medicine, Cooper University Health Care and Cooper Medical School of Rowan University, 1 Cooper Plaza D429, Camden, NJ, 08103, USA.
Pamela CrabtreeDepartment of Quality Improvement, Cooper University Health Care, Camden, NJ, USA.
Divyesha PatelDepartment of Medicine, Cooper University Health Care, Camden, NJ, USA.
Andrew HokeDepartment of Medicine, Cooper University Health Care, Camden, NJ, USA.
Ricardo Jaime OrozcoDepartment of Medicine, Inspira Health, Vineland, NJ, USA.
George SangahDepartment of Critical Care, Community Hospital North, Indianapolis, IN, USA.
Alvin MercadoCooper Medical School of Rowan University, Camden, NJ, USA.
Nicole MelchiorreCooper Medical School of Rowan University, Camden, NJ, USA.
Mariane CharronDepartment of Critical Care Medicine, Cooper University Health Care and Cooper Medical School of Rowan University, 1 Cooper Plaza D429, Camden, NJ, 08103, USA.
Abhimanyu ChandelDepartment of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
Nitin PuriDepartment of Critical Care Medicine, Cooper University Health Care and Cooper Medical School of Rowan University, 1 Cooper Plaza D429, Camden, NJ, 08103, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe efficacy of the SEP-1 Bundle has been questioned in the treatment of patients with hospital-acquired sepsis. We aimed to investigate bundle compliance and its association with survival in a subset of patients with HA sepsis: those with ICU-acquired sepsis.

methodsA single-center retrospective cohort study was conducted in a tertiary care referral hospital. Adult patients diagnosed with ICU-acquired sepsis between 1 January 2019 and 31 December 2022 were identified. Survival to hospital discharge adjusted for disease severity based on 3-hour, 6-hour, and total bundle compliance was calculated. Secondary outcomes included the need for mechanical ventilation, vasopressors, initiation of acute hemodialysis, and discharge location.

resultsOf 191 patients with ICU-acquired sepsis, 61 patients (31.9%) demonstrated total bundle compliance. There was no difference in survival based on the unadjusted analysis of 3-hour bundle compliance, compliant versus non-compliant (78.9% vs. 67.0%; P = 0.100). However, there was a survival benefit in 6-hour and total bundle, compliance versus non-compliance (82.2% vs. 60.0%, P < 0.001; 86.9% vs. 64.6%, P = 0.002). When adjusted for SOFA and CCI, logistic regression demonstrated similar results: 3-hour compliance (OR: 0.60; 95% CI: 0.29-1.18, P = 0.150), 6-hour compliance (OR: 0.35; 95% CI: 0.17-0.68, P = 0.002) and total compliance (OR: 0.31; 95% CI: 0.13-0.69, P = 0.006). Components of the SEP-1 Bundle that showed a mortality benefit included the collection of "blood cultures prior to antibiotic administration" (OR: 0.46; 95% CI 0.22-0.96, P = 0.037) and "tissue perfusion assessment" (OR: 0.41; 95% CI 0.18-0.90, P = 0.028).

conclusionsSix-hour and total SEP-1 bundle compliance was associated with increased hospital survival in patients with ICU-acquired sepsis. These findings suggest the importance of sepsis bundle compliance in the ICU environment. CLINICAL TRIAL NUMBER: Not Applicable.

Indexed as

Cross InfectionGuideline AdherenceIntensive Care UnitsPatient Care BundlesSepsisAdultAgedCohort StudiesFemaleHospital MortalityHumansMaleMiddle AgedRetrospective StudiesICU-acquired sepsisNosocomial sepsisSEP-1 bundleSepsisSepsis bundle compliance

Identifiers

PMID40394519
PMCPMC12093641

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LicenceCC BY-NC-ND
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Registered trials

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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.