Abstract
ABSTRACTObjective To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital.Methods A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records.Results We evaluated 466 patients, 58% were men, median age was 40 years, and 146 (31%) of them were diagnosed with sepsis. The overall mortality was 20% being significantly higher for patients with sepsis (39%). The factors associated with intensive care unit mortality were the presence of sepsis (OR: 6.1, 95%CI: 3.7-10.5), age (OR: 3.6, 95%CI: 1.4-7.2), and length of hospital stay (OR: 0.96, 95%CI: 0.94-0.98). Pulmonary (49%) and intra-abdominal (20%) infections were most commonly identified sites, and coagulase-negative staphylococci and enteric Gram negative bacilli the most frequent (66%) pathogens isolated.Conclusion Although the impact of sepsis on mortality is related to patients’ clinical and epidemiological characteristics, a critical evaluation of these data is important since they will allow the direct implementation of local policies for managing this serious public health problem.
Highlights
Sepsis is defined as “life threatening organ dysfunction caused by a dysregulated host response to infection”.(1) With the technical improvements in Advanced Life Support in the last few years, more patients presented with sepsis
In Brazil, sepsis is responsible for nearly 13% of all intensive care unit (ICU) admissions, and the number of deaths due to sepsis has increased by approximately 6%, from 2000 to 2010.(2-4) Data from the Instituto Latino Americano da Sepse (ILAS) show that sepsis-related mortality rate, at Brazilian private and public hospitals, ranges from 30% to 70%, respectively.[5,6] Factors related to mortality include time to initiate on antibiotics, infection control, and fluid infusion, in addition to factors intrinsic to patients, such as age and comorbidities.[7]
A total of 35.5% of admissions occurred in the pediatric ICU, while 65.5% were in the adult ICU, and sepsis was one of the complications in 146 (31%) hospitalizations
Summary
Sepsis is defined as “life threatening organ dysfunction caused by a dysregulated host response to infection”.(1) With the technical improvements in Advanced Life Support in the last few years, more patients presented with sepsis. In Brazil, sepsis is responsible for nearly 13% of all intensive care unit (ICU) admissions, and the number of deaths due to sepsis has increased by approximately 6%, from 2000 to 2010.(2-4) Data from the Instituto Latino Americano da Sepse (ILAS) show that sepsis-related mortality rate, at Brazilian private and public hospitals, ranges from 30% to 70%, respectively.[5,6] Factors related to mortality include time to initiate on antibiotics, infection control, and fluid infusion, in addition to factors intrinsic to patients, such as age and comorbidities.[7]. In Brazil, information on the clinical impact of sepsis in public hospitals, as well as data on the prevalence of microorganisms associated with severe infections in ICU are scarce. In this study we describe the clinical, epidemiological, and microbiological findings of patients admitted to ICU of a Brazilian public tertiary hospital, and compare the data from patients with and without sepsis. The Research Ethics Committee of the organization approved this study (CAAE: #03377612.5.0000.0096)
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