Sepsis is the most common critical illness encountered in the emergency department.
Much of the resuscitation of patients with sepsis is focused on early and appropriate antibiotic administration, appropriate fluid resuscitation, vasopressor support, and continued hemodynamic monitoring.
Another critical pillar in sepsis resuscitation is source control. To date, there is varying literature on the optimal timing of source control in sepsis.
In a recent cohort study of approximately 5,000 patients with community-acquired sepsis, Reitz and colleagues report a 29% reduction in risk-adjusted odds of 90-day mortality for patients who had early source control (< 6 hours) compared to those with late source control (6-36 hours).
The greatest reduction in risk-adjusted 90-day mortality with early source control occurred in patients with gastrointestinal/abdominal and soft-tissue sources of infection.
Take Home Pearl: Early source control matters in sepsis resuscitation, especially in sicker patients with a GI or soft-tissue source of infection.
Reitz KM, et al. Association between time to source control in sepsis and 90-day mortality. JAMA Surgery. 2022; 157:817-826.