Complex Sepsis Presentations, SEP-1 Compliance, and Outcomes
Authors' conclusion
In this cohort study of adults with sepsis, complex clinical presentations were more common among patients whose treatment was noncompliant with SEP-1. These nuances are poorly captured in most observational studies but confound the association between SEP-1 compliance and mortality.
Study context
- Population
- Adults with sepsis in the ED of 4 academic hospitals, 2019–2022
- Participants
- 590 adults · 4 academic hospitals
- Exposure
- SEP-1-compliant vs noncompliant care
- Compliantn = 335reference
- Noncompliantn = 225
- Outcome
- (1) Characteristics of patients with SEP-1-compliant vs noncompliant care; (2) association between SEP-1 compliance and hospital mortality, successively adjusted for more confounders
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Patient characteristics, noncompliant vs compliant
Noncompliant vs CompliantOdds ratio (95% CI)
Age ≥65 y: 142 [55.7%] vs 158 [47.2%]
1.41(1.01–1.95)
Elixhauser score >20: 99 [38.8%] vs 99 [29.6%]
1.51(1.07–2.13)
Septic shock: 107 [42.0%] vs 107 [31.9%]
1.54(1.10–2.16)
Kidney dysfunction: 87 [34.1%] vs 80 [23.9%]
1.65(1.15–2.37)
Thrombocytopenia: 43 [16.9%] vs 37 [11.0%]
1.16(1.02–2.62)
Nonfebrile presentation: 136 [53.3%] vs 121 [36.1%]
2.02(1.45–2.82)
Impaired mental status: 92 [36.1%] vs 94 [28.1%]
1.45(1.02–2.05)
Need for bedside procedures: 57 [22.4%] vs 41 [12.2%]
2.06(1.33–3.21)
Acute concurrent noninfectious illness: 140 [54.9%] vs 151 [45.1%]
1.48(1.07–2.06)
Noninfectious illness as primary factor: 84 [32.9%] vs 71 [21.2%]
1.82(1.08–3.08)
Observational data: associations, not effects.
Further findings
Hospital mortality
- No statistically significant difference after successive adjustment
- Multivariable models with successive adjustment
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Complex Sepsis Presentations, SEP-1 Compliance, and Outcomes. JAMA Netw Open. Published 3 March 2025. doi:10.
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