Skip to content
Research Article Open access CC BY 4.0

Relative Impact of the 2012 SSC Guideline Recommendations under the Scope of Numbers Needed to Treat (NNTs)

Florian Lautenschlager, Franz Porzsolt, Manfred Weiss

Journal of Advances in Medicine and Medical Research · pp. 1–15 · Published 9 Dec 2014

10.9734/BJMMR/2015/14057

Abstract

The surviving sepsis campaign (SSC) guidelines aimed to reduce mortality in severe sepsis and septic shock. The present study was performed to find out which and how many recommendations of the 2012 SSC update were based on significant effects from clinical studies in adult patients with severe sepsis and septic shock, leading to numbers needed to treat (NNTs). Every reference of the SSC 2012 guideline regarding clinical trials in adult patients was screened for absolute risk reduction regarding mortality to calculate NNTs. 17 relevant clinical trials out of 338 were identified. The NNTs ranged between 3.55 to 23.24. Significant reductions of mortality were detected, and items recommended in the SSC guidelines regarding early goal directed therapy (EGDT)/standard operating procedures (SOP)/sepsis bundles, early therapy with antibiotics, combined antibiotic therapy, and use of norepinephrine. Therapy with norepinephrine and the 6h bundles revealed the lowest NNTs. Significant reductions in mortality with restricted or no recommendations regarded therapy with hydrocortisone, therapy with high-dose antithrombin III, and enteral feeding with eicosapentaenoic acid, gamma-linolenic acid and antioxidants. In conclusion, only a few recommendations of the 2012 SSC guidelines are based on significant beneficial effects coming from clinical trials in patients with severe sepsis and septic shock. When transferring study results and NNTs, physicians should take into account the own setting and own subgroup of patients. If feasible, costs of additional treatment success may be quantified underlying NNTs.

Sepsis septic shock severe sepsis surviving sepsis campaign guidelines number needed to treat

References (22)

  1. 1 Efficacy and Safety of Recombinant Human Activated Protein C for Severe Sepsis [DOI]
  2. 2 Effect of Treatment With Low Doses of Hydrocortisone and Fludrocortisone on Mortality in Patients With Septic Shock [DOI]
  3. 3 Hydrocortisone Therapy for Patients with Septic Shock [DOI]
  4. 4 Goal-Directed Resuscitation for Patients with Early Septic Shock [DOI]
  5. 5 Comparison of Dopamine and Norepinephrine in the Treatment of Shock [DOI]
  6. 6 Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (COVID-19) [DOI]
  7. 7 Drotrecogin Alfa (Activated) for Adults with Severe Sepsis and a Low Risk of Death [DOI]
  8. 8 Epidemiology of sepsis in Germany: results from a national prospective multicenter study [DOI]
  9. 9 Implementation of a bundle of quality indicators for the early management of severe sepsis and septic shock is associated with decreased mortality* [DOI]
  10. 10 The impact of compliance with 6-hour and 24-hour sepsis bundles on hospital mortality in patients with severe sepsis: a prospective observational study [DOI]
  11. 11 Before–after study of a standardized hospital order set for the management of septic shock* [DOI]
  12. 12 Impact of the Surviving Sepsis Campaign protocols on hospital length of stay and mortality in septic shock patients: Results of a three-year follow-up quasi-experimental study* [DOI]
  13. 13 Drotrecogin alfa (activated) treatment in severe sepsis from the global open-label trial ENHANCE: Further evidence for survival and safety and implications for early treatment* [DOI]
  14. 14 Early versus delayed administration of norepinephrine in patients with septic shock [DOI]
  15. 15 Confidence Limits Made Easy: Interval Estimation Using a Substitution Method [DOI]
  16. 16 Combination antibiotic therapy with macrolides improves survival in intubated patients with community-acquired pneumonia [DOI]
  17. 17 The GRADE System for Rating Clinical Guidelines [DOI]
  18. 18 High-dose antithrombin III in the treatment of severe sepsis in patients with a high risk of death: Efficacy and safety* [DOI]
  19. 19 Outcome of Septic Shock in Older Adults After Implementation of the Sepsis “Bundle” [DOI]
  20. 20 Costs of Additional Treatment Success (COATS) Based on Numbers Needed to Treat (NNT) is a Simplified Calculation Method to Facilitate Physicians Medical Decisions with Regards to Monetary Costs [DOI]
  21. 21 Surviving Sepsis Campaign Bundles Adherence and Their Limits in Surgical Patients with Septic Shock in an ICU [DOI]
  22. 22 The Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis and Septic Shock: 2008. An assessment by the Australian and New Zealand Intensive Care Society [DOI]

Cited by 0

No indexed citations yet.

Related research

Article metrics

Real usage data collected on this platform.

42

Page views

0

PDF downloads

19

Outbound clicks

0

Citations

Views over time

Views by country

Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".

Traffic sources

Referring site, by host.

Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.