This research explored whether completing the 1-hour resuscitation bundle influences clinical outcomes in patients suffering from septic shock. The analysis utilized prospectively gathered data from multiple centers involving individuals who received standardized bundle-based resuscitation in emergency departments. Using multivariable logistic regression, in-hospital mortality was assessed according to whether the 1-hour bundle was fulfilled. Participants were further classified into three subgroups based on completion time to evaluate temporal outcome differences: group 1 (≤1 hour, reference), group 2 (1–3 hours), and group 3 (3–6 hours). Among the 1,612 patients included, only 461 (28.6%) achieved bundle completion within the first hour. Statistical evaluation showed that completing the 1-hour bundle did not significantly reduce in-hospital mortality when compared to those exceeding one hour (odds ratio = 0.74, p = 0.091). Conversely, meeting the 3-hour and 6-hour bundle targets was linked to substantially lower mortality odds (<3 vs. >3 hours and <6 vs. >6 hours; odds ratio = 0.604 and 0.458, respectively). No significant mortality variation was observed between groups 2 and 3 compared with the reference group. The findings indicate that adherence to the 1-hour bundle alone may not yield better survival outcomes in septic shock, underscoring the necessity for additional studies to clarify its clinical importance.
