Abstract
Severe sepsis is a major public health concern and a frequent cause of intensive care unit (ICU) admission with a high fatality rate. Higher (Sequential Organ Failure Assessment score) SOFA score and co-morbidity of acute renal failure (ARF) are risk factors contributing to fatal outcome. This work was meant to study the epidemiology of sepsis in Buraidah central hospital. This is a descriptive study conducted in the period from January 1, 2012, to June 29, 2012 to determine the epidemiology (incidence, clinical characteristics) and the outcome of sepsis in Buraidah hospital, Saudi Arabia. Out of 387 patients admitted to ICU, 62 (16%) patients had sepsis, their mean (SD) age was 62.7 (21.3) years. Three quarters of them 47 (75.8%) presented with septic shock. The median APACHE II score was 26.5 (8 to 48) and SOFA score 11 (5 to 21). The mean of duration of hospital stay was 11.95 days. The most frequent infection site was the pulmonary (69.5%). There were 37 isolated organism, gram-negative organisms (13; 35.13%) were the predominant isolates. There were 25 (40.3%) deaths; the majority of the deaths were due to septic shock 20(80%). There was a significant difference between deaths and the survivors, in the APACHI II score, SOFA score), and whether ventilated or not. There was a high incidence of septic shock (and higher mortality) among the patients admitted to the ICU of Buraidah central hospital, especially among the elderly patients with respiratory infections.
Highlights
Sepsis is a clinical syndrome featured by multi-system response to a microbial pathogenic insult encompassing conglomerate of related biochemical, cellular, and organorgan interaction networks
(18) It has been found that maximum total Sequential Organ Failure Assessment” (SOFA) score exceeding 15 correlates with a mortality rate of 90%. [19] It was demonstrated that approximately 60% of an intensive care units (ICUs) budget was kept for sepsis and septic shock patients, albeit that those patients constituted less than a quarter of the ICU population. [20,21,22] The aim of this study was to determine the frequency and the clinical characteristics of sepsis in a hospital-based population in Al-Qassim region, Saudi Arabia
There was a significant difference between the two groups in the APACHI II score (p value =0.008), SOFA score (p value
Summary
Sepsis is a clinical syndrome featured by multi-system response to a microbial pathogenic insult encompassing conglomerate of related biochemical, cellular, and organorgan interaction networks. Severe sepsis and septic shock are recognized causes of admission, morbidity and mortality in intensive care units (ICUs). [14] The definition embraced sepsislinked organ dysfunction, hypoperfusion or hypotension (severe sepsis), and septicinduced cardiovascular failure in spite of adequate fluid resuscitation (septic shock). [15] Along with the efforts made to improve the diagnostic criteria, criteria helping prediction of the outcome were developed such APACHE II which was the result refinement of APACHE I in 1985 based on data extracted from 5815 ICU admissions at 13 different hospitals. [18] It has been found that maximum total SOFA score exceeding 15 correlates with a mortality rate of 90%. [19] It was demonstrated that approximately 60% of an ICU budget was kept for sepsis and septic shock patients, albeit that those patients constituted less than a quarter of the ICU population. While APACHI II assess the severity of disease on admission(during the first 24 hours), [17] another scoring system namely “The Sequential Organ Failure Assessment” (SOFA) score was meant to assess the existence and extent of organ failure, characterized by being simple and objective, allowing for calculation of both the number dysfunctional organs involved and the severity of the involvement in six organ systems (pulmonary, coagulation, liver, cardiovascular, kidney, and the central nervous system), and it can assess individual or aggregate organ dysfunction. [18] It has been found that maximum total SOFA score exceeding 15 correlates with a mortality rate of 90%. [19] It was demonstrated that approximately 60% of an ICU budget was kept for sepsis and septic shock patients, albeit that those patients constituted less than a quarter of the ICU population. [20,21,22] The aim of this study was to determine the frequency and the clinical characteristics of sepsis in a hospital-based population in Al-Qassim region, Saudi Arabia
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