# Implementation of a Sepsis Code Protocol at an Academic Institution in Colombia: A Pilot Study

## TL;DR

A pilot study in Colombia found that implementing a sepsis code protocol was associated with lower in-hospital mortality compared to standard care.

## Contribution

This study demonstrates the potential effectiveness of a sepsis code protocol in reducing mortality in a resource-limited setting.

## Key findings

- Patients under the Sepsis Code protocol had 13.4% mortality versus 22.5% in the control group (p = 0.042).
- The intervention was associated with a 47% lower mortality risk (OR, 0.53; 95% CI, 0.29–0.94).
- Factors like lactate levels, SOFA score, septic shock, and diabetes history increased mortality risk.

## Abstract

Background/Objectives: Sepsis is a critical medical emergency with significant morbidity and mortality, particularly in resource-limited countries. Effective strategies are essential to lower the high death rate. The sepsis code protocol recommends coordinated, structured, and prompt interventions for thorough patient care. This study aimed to compare in-hospital mortality rates after implementing the Sepsis Code protocol with those of a cohort of patients previously treated according to standard institutional guidelines. Methods: A pilot quasi-experimental study using a historical cohort design was conducted, involving patients with sepsis treated in an emergency department. Bivariate and multivariate analyses, as well as survival analysis, were conducted to evaluate the effectiveness of the intervention. Results: A total of 342 patients were analyzed. Among those who received the intervention, mortality was 13.4%, while in the control group, it was 22.5% (p = 0.042). Additionally, a protective association was found between the intervention and mortality (OR, 0.53; 95% CI, 0.29–0.94). Factors associated with increased mortality risk included lactate levels, SOFA score, septic shock presence, and history of diabetes. Conclusions: The implementation of the Sepsis Code in the emergency area showed an association with lower in-hospital mortality, especially in patients with septic shock. However, due to the study’s design, further research is needed to employ more robust methodologies and confirm the protocol’s applicability in the region.