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Impact of Prehospital Antibiotic Therapy on Septic Shock Mortality

机译：预孢子抗生素治疗对化脓性休克死亡率的影响

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Background: Septic shock (SS) is associated with high morbidity and mortality rate. Early antibiotic therapy administration in septic patients was shown to reduce mortality but its impact on mortality in a prehospital setting is still under debate. To clarify this point, we performed a retrospective analysis on patients with septic shock who received antibiotics in a prehospital setting. Methods: From April 15(th), 2017 to March 1(st), 2020, patients with septic shock requiring Mobile Intensive Care Unit (MICU) intervention were retrospectively analyzed to assess the impact of prehospital antibiotic therapy administration on a 30-day mortality. Results: Three-hundred-eight patients with septic shock requiring MICU intervention in the prehospital setting were analyzed. The mean age of the study population was 70 +/- 15 years. Presumed origin of SS was mainly pulmonary (44%), digestive (21%) or urinary (19%) infection. Overall 30-day mortality was 29%. Ninety-eight (32%) patients received antibiotic therapy. Using Cox regression analysis, we showed that prehospital antibiotic therapy significantly reduces 30-day mortality for patients with septic shock (hazard ratio = 0.56, 95%CI [0.35-0.89], p = 0.016). Conclusion: In this retrospective study, prehospital antibiotic therapy reduces 30-day mortality of septic shock patients cared for by MICU. Further studies will be needed to confirm the beneficial effect of prehospital antibiotic therapy in association or not with prehospital hemodynamic optimization to improve the survival of septic shock patients.
机译：背景：感染性休克（SS）具有较高的发病率和死亡率。脓毒症患者的早期抗生素治疗可降低死亡率，但其对院前环境中死亡率的影响仍存在争议。为了阐明这一点，我们对在院前接受抗生素治疗的感染性休克患者进行了回顾性分析。方法：从2017年4月15日至2020年3月1日，对需要移动重症监护病房（MICU）干预的感染性休克患者进行回顾性分析，以评估院前抗生素治疗对30天死亡率的影响。结果：分析了在院前环境中需要MICU干预的38例感染性休克患者。研究人群的平均年龄为70+/-15岁。推测SS的来源主要是肺部（44%）、消化道（21%）或泌尿道（19%）感染。总的30天死亡率为29%。98例（32%）患者接受了抗生素治疗。通过Cox回归分析，我们发现院前抗生素治疗可显著降低感染性休克患者的30天死亡率（危险比=0.56，95%可信区间[0.35-0.89]，p=0.016）。结论：在这项回顾性研究中，院前抗生素治疗降低了MICU治疗的感染性休克患者的30天死亡率。需要进一步的研究来证实院前抗生素治疗是否与院前血流动力学优化相关，以提高感染性休克患者的生存率。

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