{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:06:19Z","timestamp":1785405979405,"version":"3.56.0"},"reference-count":30,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T00:00:00Z","timestamp":1785369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background. Sepsis is a leading, time-dependent cause of in-hospital death, and guidelines now prioritize organized care such as code-sepsis protocols. Yet little is known about the long-term activity, organization and outcomes of permanent, hospital-scale programs. We characterized the activity of a hospital-wide multidisciplinary sepsis unit (MSU) over thirteen years and evaluated mortality trends. Methods. Retrospective cohort study using the registry of a hospital-wide MSU (2011\u20132023). The analysis unit was the sepsis event. Activity, referral pathways, interventions, follow-up and mortality were analyzed; temporal trends used multivariable logistic regression and standardized mortality ratios (SMR). Results. The unit attended 10,874 patients across 15,723 events and 50,925 consultations (median age 67; 59.3% men), referred mainly through the sepsis code (45.0%) and, increasingly, proactive early-warning detection (15.2%). An antibiotic change was recommended in 57.2% of events, and 89.8% of all suggested changes were implemented. Follow-up was sustained (median 3 visits; 61.8%). In-hospital mortality was 7.6%, and 11.8% in protocol-confirmed sepsis. Crude mortality did not fall, but severity rose (organ dysfunctions 1.67 to 2.72; septic shock 8 to 13%; both p &lt; 0.001) with stable age; after adjustment the calendar-year effect disappeared (adjusted OR 1.00\/year, p = 0.70) and the SMR stayed near 1.0, including pandemic years. Age, ICU admission (OR 2.65) and organ-dysfunction count (OR 1.37) independently predicted death. Conclusions. Over thirteen years, this hospital-wide MSU delivered large-scale, multi-channel, longitudinal care to an increasingly severe population while maintaining stable risk-adjusted mortality, supporting the long-term feasibility of a model integrating early detection, multidisciplinary decision-making, antimicrobial stewardship and follow-up.<\/jats:p>","DOI":"10.3390\/antibiotics15080737","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T09:32:13Z","timestamp":1785403933000},"page":"737","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Activity and Outcomes of a Multidisciplinary Sepsis Unit: Fifty Thousand Consultations over Thirteen Years"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9929-3111","authenticated-orcid":false,"given":"Marcio","family":"Borges-Sa","sequence":"first","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"},{"name":"Faculty of Medicine, Balearic Islands University, 07122 Palma, Spain"},{"name":"Fundaci\u00f3n Codigo Sepsis, 46003 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9876-4080","authenticated-orcid":false,"given":"Elena","family":"Martin-Martinez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Balearic Islands University, 07122 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Aranda","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7435-8115","authenticated-orcid":false,"given":"Antonia","family":"Socias","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"},{"name":"Faculty of Medicine, Balearic Islands University, 07122 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-6587","authenticated-orcid":false,"given":"Sofia","family":"Tejada","sequence":"additional","affiliation":[{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"del Castillo","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Garau","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis","family":"P\u00e9rez de Amezaga","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joana","family":"Mena","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andres","family":"Giglio","sequence":"additional","affiliation":[{"name":"Multidisciplinary Sepsis Unit, Son Llatzer Hospital, 07198 Palma, Spain"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain"},{"name":"Faculty of Medicine, Balearic Islands University, 07122 Palma, Spain"},{"name":"Critical Care Center, Cl\u00ednica Las Condes Hospital, Santiago 7591046, Chile"},{"name":"Faculty of Medicine, Finis Terrae University, Santiago 7640471, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","unstructured":"GBD 2021 Global Sepsis Collaborators (2025). 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