Association Between Time to Source Control in Sepsis and 90-Day Mortality

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Surgical Outcomes

Background:

• Prompt source control is crucial for improving patient outcomes in sepsis.
• However, limited data exist to precisely define the optimal timing for source control interventions.

Purpose of the Study:

• To investigate the association between the time to source control and patient outcomes in cases of community-acquired sepsis.
• To quantify the impact of delayed source control on mortality rates.

Main Methods:

• A multihospital cohort study included hospitalized adults diagnosed with community-acquired sepsis (Sepsis-3 criteria) between 2013 and 2017.
• Patients undergoing source control procedures were analyzed, comparing early (<6 hours) versus late (6-36 hours) intervention timing.
• Multivariable models adjusted for patient factors, sepsis severity, and procedure-related stress were used to assess outcomes.

Main Results:

• The median time to source control was 15.4 hours after sepsis onset; 27% of patients received intervention within 6 hours.
• Early source control (<6 hours) was associated with a significantly reduced risk-adjusted odds of 90-day mortality (aOR, 0.71; 95% CI, 0.63-0.80).
• This survival benefit was most pronounced for gastrointestinal/abdominal and soft tissue interventions.

Conclusions:

• Initiating source control within 6 hours of community-acquired sepsis onset is linked to decreased 90-day mortality.
• Prioritizing rapid identification and intervention for septic foci can prevent a substantial number of sepsis-related deaths.
• These findings support the implementation of time-sensitive protocols for sepsis management.