Analysis of Structure Indicators Influencing 3-h and 6-h Compliance with the Surviving Sepsis Campaign Guidelines in China: A Systematic Review

Abstract Background: Compliance with the surviving sepsis campaign (SSC) guidelines (Cssc) is a key factor affecting the effects of sepsis treatment. We designed this study to investigate the relationships of the structure indicators of ICU on 3-h and 6-h Cssc in China. A total of 1854 hospitals were enrolled in a survey, led by the China National Critical Care Quality Control Center (China-NCCQC) from January 1, 2018, through December 31, 2018.Methods: We investigated the 1854 hospitals’ 3-h and 6-h Cssc, including compliance with each specific measure of the 3-h and 6-h SSC bundles. We also investigated the actual level of the structure indicators of ICU, released by China-NCCQC in 2015.The outcomes were in adherence with the SSC guidelines (2016). Monitoring indicators included 3-h and 6-h Cssc.Results: In the subgroup, the rate of broad-spectrum antibiotic therapy was the highest, and the rate of CVP and ScvO2 measurement was the lowest. Structure indicators related to 3-h and 6-h Cssc include the predicted mortality rate and the standardized mortality ratio (SMR). The relationships between 3-h and 6-h Cssc and the proportion of ICU in total inpatient bed occupancy, the proportion of acute physiology and chronic health evaluation (APACHE) II score ≥15 in all ICU patients were uncertain. There was no relationship of 3-h and 6-h Cssc with the proportion of ICU patients among total inpatients.Conclusions: Structure indicators influencing 3-h and 6-h Cssc in China are the predicted mortality rate and the standardized mortality rate.