Survival Rate of Adult Patients With Sepsis Following the Clinical Practice Guidelines for Initial Management of Sepsis in a Tertiary Hospital in Iloilo – A Retrospective Cohort Study

Abstract RATIONALE: Early recognition and prompt intervention are essential for effective sepsis management, which includes intravenous fluid administration within the first 3 hours, broad-spectrum antibiotic administration within 1 hour, and specimen culture collection. However, achieving these time-sensitive interventions remains a challenge for physicians. This study aims to determine the survival rate of adult patients with sepsis and compare outcomes based on adherence to initial management protocols, following clinical practice guidelines. METHODS: This retrospective study analyzed 74 adult patients diagnosed with sepsis at Iloilo Doctors’ Hospital from January 1, 2023, to December 31, 2023. Initial sepsis management was categorized by adherence to three guideline components: fluid resuscitation, broad-spectrum antibiotic administration, and specimen culture collection. Survival rates were evaluated using Kaplan-Meier analysis, while treatment group comparisons were assessed using Analysis of Variance and Post Hoc test to establish statistical significance among different management approaches. RESULTS: The study found that patients who received comprehensive initial management (fluid resuscitation, antibiotics, and specimen culture) had the highest restricted mean survival (31.826), indicating significantly improved outcomes compared to those who received partial or no guideline-based management. Significant p-values were observed in the survival comparisons: fully administered versus not administered (p < 0.001), culture alone versus fully administered (p = 0.002), fluids and antibiotics versus not administered (p = 0.005), and antibiotics alone versus not administered (p = 0.018). These findings indicate that each component of guideline-based initial management plays a critical role in patient survival. CONCLUSION: This study highlights the importance of early and comprehensive sepsis management in improving survival rates, demonstrating that adherence to clinical guidelines—comprising fluid resuscitation, timely initiation of broad-spectrum antibiotics, and specimen culture collection—significantly enhances patient outcomes, even in a third-world country setting. Regardless of the location, strict compliance with clinical practice guidelines can improve health outcomes and reduce sepsis-associated mortality.