Septic Shock Treatment Protocols Challenged

Cheryl Clark, for HealthLeaders Media , March 19, 2014

The NQF issued this statement when reached for comment Tuesday: "NQF's Patient Safety Measures Standing Committee is empanelled and will conduct an ad hoc review of this measure as a result of this newly published study at its April 17−18 meeting."

Under contract with the Centers for Medicare & Medicaid Services, the NQF has endorsed more than 700 measures of care, which guide how physicians and others treat patients both in hospital and ambulatory care settings.

The new ProCESS trial divided patients with septic shock who came to emergency departments of 31 hospitals into three groups to receive:

  • Protocol-based early-goal directed therapy (EGDT),
  • Protocol-based standard therapy, or
  • Usual care

The outcome measure was death from any cause in the hospital within 60 days or death from any cause at 90 days, and cumulative mortality at 90 days and one year.

When the data was unlocked, the 60-day death rates were as follows: 21% of patients in the EGDT group, 18.2% in the protocol standard-therapy group and 18.9% in the usual-care group. And "there were no significant differences in 90-day mortality, one-year mortality or the need for organ support."

Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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