Objectives:

To assess time to antibiotics, vasopressor use, percent of ICU admissions, 72 hour and in-hospital and 28-day mortality among patients presenting to the Emergency Department with severe sepsis after implementation of the protocolized sepsis diagnosis and management bundle (EGDT) and compare them to severe sepsis patients managed prior to the initiation of the protocol.

Aims:

-To assess demographics, focus of infection, time to antibiotics, length of stay and clinical outcome of patients presenting to the ED with severe sepsis who are treated with a protocolized sepsis diagnosis and management bundle.  

Study Endpoints:

Primary Outcome: 72 hours, in-hospital and 28-day mortality

Secondary Outcome: length of stay, time to antibiotics, percent of ICU admission, amount of IV fluid use, vasopressor use. 

Subjects:

Patients receiving final diagnosis of “severe sepsis”

Age ≥ 18 years

The AUBMC ED and ICD-9 clinical databases will be queried for the period between January 1^st  2013 and November 14^th 2014, looking for patients presenting to and admitted through AUBMC ED and placed on the severe sepsis protocol (this will be the intervention group), and a period between January 1, 2004 and December, 2012 looking at a number matching sample of patients (in terms of demographics, age, sex and type of infection) presenting and admitted through AUBMC ED with a final diagnosis of severe sepsis prior to the initiation of the severe sepsis protocol (this will be the historical control group).

Patients will be assessed for demographical information, vital signs, laboratory tests, ICU vs general floor admission, time to antibiotics in-hospital, and 28-day mortality (please refer to data collection sheet).