Ann Intern Med

Does the CMS sepsis management bundle lower mortality?

March 5, 2025

The review highlights the need for cautious interpretation of Severe Sepsis and Septic Shock Management Bundle (SEP-1) compliance and implementation data due to methodological limitations and inconsistent results. While some studies suggest potential benefits, overall evidence doesn't robustly support SEP-1 as a mortality-reducing measure.

Study details: This systematic review assessed the impact of compliance with SEP-1 on mortality among sepsis patients and included 17 observational studies that evaluated either SEP-1 compliance or implementation, using data from multiple databases up to November 2024. Studies were assessed for risk of bias and the level of evidence was determined using GRADE criteria.

Results: Out of 17 studies, 12 examined the relationship between SEP-1 compliance and mortality, with 5 showing statistically significant benefits. However, these studies had limitations such as lack of adjustment for confounders and heterogeneity in patient populations. The remaining 5 studies focused on SEP-1 implementation, with only 1 showing a significant benefit, but it didn't account for pre-implementation mortality trends. All included studies were observational and had varying degrees of bias, precluding a meta-analysis.

Source:

Ford JS, et al. (2025, February 18). Ann Intern Med. The Effect of Severe Sepsis and Septic Shock Management Bundle (SEP-1) Compliance and Implementation on Mortality Among Patients With Sepsis : A Systematic Review. https://pubmed.ncbi.nlm.nih.gov/39961104/