TRENDS AND PREDICTORS OF MORTALITY IN SEPTIC SHOCK PATIENTS TREATED WITH SURVIVING SEPSIS CAMPAIGN GUIDELINE BUNDLES
DOI:
https://doi.org/10.71000/2wgxgv72Keywords:
Antibiotic Therapy; Bundle Compliance; Critical Care; Lactate; Mortality; Sepsis; Septic Shock.Abstract
Background: Septic shock remains a leading cause of mortality among critically ill patients worldwide. Timely recognition and management based on the Surviving Sepsis Campaign (SSC) guidelines have been shown to improve outcomes. However, adherence to 1-hour and 3-hour care bundles varies across institutions, influencing patient survival.
Objective: To evaluate trends and predictors of mortality among patients with septic shock managed according to SSC guideline bundles, focusing on compliance with 1-hour and 3-hour bundle components.
Methods: A retrospective observational study was conducted at Hameed Latif Hospital, Lahore, from January to December 2025. Adult patients (≥18 years) diagnosed with septic shock based on Sepsis-3 criteria were included. Data on demographics, comorbidities, laboratory findings, and bundle compliance were collected from electronic medical records. The primary outcome was in-hospital mortality. Statistical analysis was performed using SPSS version 26.0. Associations between mortality and bundle compliance were assessed using chi-square tests, and predictors of mortality were determined through multivariate logistic regression. A p-value <0.05 was considered significant.
Results: A total of 400 patients were included, with a mean age of 58.3 ± 15.6 years and a male predominance of 62.5%. The overall in-hospital mortality was 39.5%. Compliance rates for the 1-hour and 3-hour bundles were 46.8% and 71.3%, respectively. Mortality was significantly lower in patients compliant with the 1-hour (28.9% vs. 51.7%) and 3-hour bundles (31.2% vs. 54.5%). Independent predictors of mortality included age >65 years, lactate >4 mmol/L, SOFA score ≥10, and non-compliance with bundles (p<0.05).
Conclusion: Adherence to SSC 1-hour and 3-hour bundles significantly reduces mortality in septic shock. Early, structured intervention and protocol-driven management remain essential for improving outcomes in critically ill patients.
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Copyright (c) 2026 Dr Ali Rehan, Dr Wafa Hyder Maitlo, Dr Sidra Sonia Ch, Dr Nauman Khan, Dr Asim Rafiq, Dr Arif Mehmood Kamboh
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