• C Fuchs, C Scheer, M Vollmer, S Rehberg, K Meissner, S-O Kuhn, S Friesecke, P Abel, and M Gründling.
• 1Department of Anesthesiology and Intensive Care, University Hospital Greifswald, Greifswald, Germany 2Department of Mathematics und Informatics, University Greifswald, Germany 3Department of Internal Medicine B, University Hospital Greifswald, Greifswald, Germany.
• Shock. 2015 Oct 1;44 Suppl 2:15.

IntroductionHospital mortality of severe sepsis and septic shock is about 55% in Germany. An improved compliance with the resuscitation bundle of the Surviving Sepsis Campaign significantly reduced hospital mortality. However, the long-term effect upon 90-day mortality remains unclear.MethodsIn this prospective, longitudinal interventional study over 7.5 years all patients aged > 18 years with severe sepsis and septic shock treated in intensive care units (ICU) of the University Hospital of Greifswald were included. From 01/2006-12/2007, ICU-, hospital-, 28-day and 90-day mortality were registered and compared with those after the implementation of a continuous training program focusing on the resuscitation bundle (01/2008-07/2013).ResultsThere was a sustained reduction of ICU-, hospital-, 28-day and 90-day mortality for anesthesiological and medical ICUs (p < 0.005 each). 90-day mortality declined significantly in the anesthesiological ICU from 61.7% (95% CI; 52.8%-69.9%; n = 133) to 42.7% (95% CI; 39.1%-46.3%; n = 743)(p < 0.0001) and in the medical ICU from 69.1% (95% CI; 56.7%-79.8%;n = 71) to 49.3% (95% CI; 44.2%-54.5%; n = 429) (p < 0.005). The relative risk reduction in the anesthesiological ICU was 30.8% (95% CI; 18.9%-40.9%) and 28.6% (95% CI; 13.8%-40.9%) in the medial ICU, respectively.ConclusionA continuous training program for the ICU staff focusing on the resuscitation bundle significantly reduced 90-day mortality in anesthesiological and medical ICU patients with severe sepsis and septic shock.

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