Activation of code sepsis in the emergency department is associated with a decrease in mortality

Abstract Objectives To evaluate the impact of a code sepsis (CS) activation, complying with recommendations, the evolution of patients with severe sepsis in the emergency room and determine independent factors associated to mortality. Method All patients attending the emergency room with severe sepsis during a 6-month period were included. Complying with Surviving Sepsis Campaign recommendations, patients’ average stay, intensive care admissions and 30-day mortality were assessed. Two groups were compared: CS activation (A) and no activation (NA). Results A total of 114 episodes were found, 61.4% belonging to group A and 38.6% to NA. Patients in group A presented hypotension more frequently (61.5% vs. 34.4%; p  = .005). Patients in group NA more frequently had lactate levels of >3 mmol/l (48.3% vs. 80%; p  = .01), and abdominal focus of sepsis (34.3% vs. 13%; p  = .01). In group A, blood cultures were more frequently drawn in the first hour (95% vs. 41.7%; p p  = .005) and fluid replacement carried out (54.5% vs. 18.2%; p  = .01). Global achievement of CS objectives was higher in group A (31.4% vs. 9.1%; p  = .006). In group NA more patients were admitted to the intensive care unit (10% vs. 36.4%; p p p CRP >200 mg/l (OR 33.7; p p  = .001) resulted in being independent factors associated with mortality. Conclusions The implementation of a CS improves compliance with SSC recommendations and decreases intensive care admissions, average stays and mortality.