Evidence map›Paper›PMID 41488700›Full record

ArticleOpen forum infectious diseases2026

Regional Adherence to Early Sepsis Management Bundle and Associated Mortality in Hong Kong Between 2009-2018.

Jack Zhenhe Zhang, Chun Hei Chan, Lok Ching Chang, Lok Ching Sandra Chiu, Pauline Yeung Ng, Manimala Dharmangadan, Eunise Ho, Steven Ling, Man Yee Man, Ka Man Fong and 14 more

Abstract read
In one paragraph

Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

24 authors.

Jack Zhenhe ZhangDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID https://orcid.org/0000-0001-7114-7761
Chun Hei ChanFaculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
Lok Ching ChangDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Lok Ching Sandra ChiuDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Pauline Yeung NgCritical Care Medicine Unit, The University of Hong Kong, Hong Kong SAR, China.
Manimala DharmangadanDepartment of Intensive Care, Princess Margaret Hospital, Hong Kong SAR, China.
Eunise HoDepartment of Intensive Care, North District Hospital, Hong Kong SAR, China.
Steven LingDepartment of Intensive Care, Tuen Mun Hospital, Hong Kong SAR, China.
Man Yee ManDepartment of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong SAR, China.
Ka Man FongDepartment of Intensive Care, Queen Elizabeth Hospital, Hong Kong SAR, China.
Ting LiongDepartment of Intensive Care, United Christian Hospital, Hong Kong SAR, China.
Alwin Wai Tak YeungDepartment of Medicine and Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong SAR, China.
Ka Fai AuDepartment of Intensive Care, Kwong Wah Hospital, Hong Kong SAR, China.
Jacky Ka Hing ChanIntensive Care Unit, Tseung Kwan O Hospital, Hong Kong SAR, China.
Michele TangDepartment of Medicine and Geriatrics, Caritas Medical Centre, Hong Kong SAR, China.
Katy Hoi Ki LiDepartment of Intensive Care, Alice Ho Miu Ling Nethersole Hospital, Hong Kong SAR, China.
William Ka Kei WuDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Wai Tat WongDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Peng WuWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.ORCID https://orcid.org/0000-0003-1157-9401
Benjamin J CowlingWHO Collaborating Centre for Infectious Disease Epidemiology and Control, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
Kwok Ming HoDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
Anna LeeDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID https://orcid.org/0000-0003-2864-0045
Chanu RheeDepartment of Population Medicine, Harvard Medical School/Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA.
Lowell LingDepartment of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong SAR, China.ORCID https://orcid.org/0000-0001-6639-7344

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Longitudinal data are scarce on sepsis bundle adherence and associated survival at a country or regional level. Methods: A population-based electronic health record database was leveraged to determine temporal trends in sepsis bundle adherence (empirical broad-spectrum antibiotic administration, blood culture collection, lactate measurement) on sepsis onset day and antimicrobial resistance (AMR) prevalence. This study included all adult hospitalizations for community-acquired sepsis at 41 publicly funded hospitals in Hong Kong between 2009 and 2018. Generalized estimating equations were used to assess the association between full bundle adherence and its individual elements with hospital mortality. Results: Among 421 096 cases of community-acquired sepsis, the full bundle adherence rate increased from 0.2% in 2009 to 1.2% in 2018 (relative +18.9%/y, Conclusions: Basic sepsis care implementation remains challenging even in high-income settings. Empirical broad-spectrum antibiotic usage has outpaced AMR risk. Full sepsis bundle adherence was associated with improved survival, but empirical broad-spectrum antibiotics was associated with better survival only if used appropriately. Efforts should focus not only on ensuring bundle adherence but also on prioritizing the right treatments for the right patients.

Indexed as

antibioticsblood culturescompletioncompliancelactate

Identifiers

PMID41488700
PMCPMC12759782

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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.