A 450-bed teaching hospital implements a rapid sepsis recognition protocol in the emergency department, which includes automated EHR alerts for lactate >2 mmol/L and systemic inflammatory response criteria. Prior to implementation, the median time from triage to first antibiotic administration was 185 minutes (interquartile range 140–240 minutes). Six months after protocol rollout, analysis of 120 consecutive sepsis cases shows a median time of 98 minutes (IQR 70–130 minutes), with a p-value <0.001 on Mann-Whitney U testing. The hospital's quality improvement team notes this represents an absolute reduction of 87 minutes. Which of the following best describes the significance of this finding?
- A)Statistically significant but clinically insignificant, as p-values <0.001 indicate the result is likely a type I error
- B)Neither statistically nor clinically significant without a concurrent control group receiving standard care
- C)Clinically significant but not statistically significant, requiring a larger sample size to achieve p <0.05
- D)Both statistically and clinically significant; an 87-minute reduction in sepsis antibiotic administration time is associated with improved mortality outcomes in the literatureGABARITO
- E)Statistically significant due to reduced variation (lower IQR post-intervention), but the overlap in ranges suggests confounding variables affected both periods
Explicação
This improvement is both statistically significant (p <0.001) and clinically significant. The absolute reduction of 87 minutes exceeds evidence-based targets for sepsis care; guidelines recommend antibiotics within 60 minutes, and this protocol brings median a... Ver explicação completa e trilha adaptativa →