Epidemiology of severe infections in Latin American intensive care units

Ortiz, Guillermo; Dueñas, Carmelo

doi:10.5935/0103-507x.20160051

Cited by 8 publications

(9 citation statements)

References 19 publications

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“…These estimates rely on data from high-income countries, which have an average mortality rate of 17% for sepsis and 26% for severe sepsis. These figures are significantly lower than those reported in several other countries (Machado et al 2017;Ruiz and Castell 2016), meaning that the actual number of casualties could be even higher. Furthermore, the incidence of sepsis and the number of fatalities it causes are growing (Martin 2012).…”

Section: Introductioncontrasting

confidence: 64%

Sensitivity analysis–based sepsis prognosis using artificial intelligence

et al. 2020

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Sepsis is a life-threatening condition which may arise from an extreme response of the body to an infection. While worldwide figures are unknown, it is estimated that sepsis causes millions of yearly fatalities. In this context, it is important to develop tools for decision support and training of healthcare professionals. This paper proposes that artificial intelligence tools be used for prognosis of septic patients. The model used is a neural network trained and validated with cross-validation. The information used includes data regarding patient history and treatment. More importantly, this paper also presents a principled approach of using sensitivity analysis for the identification of discriminatory variables when these are of mixed types such as binary, categorical, and integer. While initial results, validated on over 5000 patients, already show both specificity and sensitivity above 80% and good model robustness against errors in most inputs, even better performance is attained through the utilization of sensitivity analysis to select the variables used as inputs. This work presents a promising tool for input selection in contexts of limited data availability, and successfully applies this technique to obtain a high-performance model for prognosis of septic patients.

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Section: Introductioncontrasting

confidence: 64%

Sensitivity analysis–based sepsis prognosis using artificial intelligence

et al. 2020

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“…Health systems vary across Latin American countries, and a mix of public and private ICUs do exist, sometimes with uneven resource distribution [ 10 , 11 ]. In our study, most intensivists worked primarily in public hospitals, but less than half worked in only one hospital.…”

Section: Discussionmentioning

confidence: 99%

The practice of intensive care in Latin America: a survey of academic intensivists

Castro

Nin²,

Ríos

et al. 2018

Crit Care

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BackgroundIntensive care medicine is a relatively young discipline that has rapidly grown into a full-fledged medical subspecialty. Intensivists are responsible for managing an ever-increasing number of patients with complex, life-threatening diseases. Several factors may influence their performance, including age, training, experience, workload, and socioeconomic context. The aim of this study was to examine individual- and work-related aspects of the Latin American intensivist workforce, mainly with academic appointments, which might influence the quality of care provided. In consequence, we conducted a cross-sectional study of intensivists at public and private academic and nonacademic Latin American intensive care units (ICUs) through a web-based electronic survey submitted by email. Questions about personal aspects, work-related topics, and general clinical workflow were incorporated.ResultsOur study comprised 735 survey respondents (53% return rate) with the following country-specific breakdown: Brazil (29%); Argentina (19%); Chile (17%); Uruguay (12%); Ecuador (9%); Mexico (7%); Colombia (5%); and Bolivia, Peru, Guatemala, and Paraguay combined (2%). Latin American intensivists were predominantly male (68%) young adults (median age, 40 [IQR, 35–48] years) with a median clinical ICU experience of 10 (IQR, 5–20) years. The median weekly workload was 60 (IQR, 47–70) h. ICU formal training was between 2 and 4 years. Only 63% of academic ICUs performed multidisciplinary rounds. Most intensivists (85%) reported adequate conditions to manage patients with septic shock in their units. Unsatisfactory conditions were attributed to insufficient technology (11%), laboratory support (5%), imaging resources (5%), and drug shortages (5%). Seventy percent of intensivists participated in research, and 54% read scientific studies regularly, whereas 32% read no more than one scientific study per month. Research grants and pharmaceutical sponsorship are unusual funding sources in Latin America. Although Latin American intensivists are mostly unsatisfied with their income (81%), only a minority (27%) considered changing to another specialty before retirement.ConclusionsLatin American intensivists constitute a predominantly young adult workforce, mostly formally trained, have a high workload, and most are interested in research. They are under important limitations owing to resource constraints and overt dissatisfaction. Latin America may be representative of other world areas with similar challenges for intensivists. Specific initiatives aimed at addressing these situations need to be devised to improve the quality of critical care delivery in Latin America.Electronic supplementary materialThe online version of this article (10.1186/s13054-018-1956-6) contains supplementary material, which is available to authorized users.

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“…São estimados anualmente, que mais de 18 milhões de pessoas sejam atingidas por sepse, e mais de 5 milhões vão a óbito. 2 Dados de um estudo epidemiológico brasileiro sobre a sepse nas Unidades de Terapia Intensiva (UTI), demonstraram que a incidência dessa enfermidade nesses setores é de 16,7%. Já o índice de mortalidade por sepse, sepse grave e choque séptico alcançou, respectivamente, 19,6%, 34,4% e 65,3%.…”

Section: Introductionunclassified

Características epidemiológicas de pacientes com sepse em unidade de terapia intensiva

Costa

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Frota

et al. 2019

Rev Epidemiol Control Infect

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Justificativa e Objetivos: Apesar das novidades relacionadas ao diagnóstico precoce e ao rastreamento microbiano dos casos de sepse, faz-se necessário compreender os aspectos clínico-epidemiológicos dos serviços de saúde visando definir as especificidades dos pacientes acometidos em Unidades de Terapia Intensiva (UTI). Nesse contexto, objetiva-se descrever as características epidemiológicas de pacientes com sepse em UTI. Métodos: Trata-se de uma pesquisa exploratória-descritiva, retrospectiva, documental, com abordagem quantitativa, realizada entre maio e julho de 2018, em hospital de ensino da Zona Norte do Estado do Ceará. Utilizou-se como fonte de dados os prontuários de pacientes que apresentaram sepse nas UTI do referido hospital, alcançando-se uma amostra de 62 prontuários para análise. Os dados coletados foram armazenados nos programas Microsoft Excel e Origin Lab 8 para posterior construção de gráficos e tabelas para análise das informações. Resultados: Os casos tiveram predominância em indivíduos do sexo masculino, residentes em municípios interioranos circunvizinhos e adultos jovens com idade entre 19 e 39 anos. O traumatismo cranioencefálico e o politraumatismo foram os diagnósticos iniciais que prevaleceram. As bactérias grampositivas tiveram maior prevalência, superando os bacilos gram-negativos e os fungos. Os antimicrobianos mais utilizados foram Cefepime e Vancomicina. As evoluções das infecções estiveram associadas a fatores como: estado de saúde dos pacientes; utilização de dispositivos invasivos e longo período de internação. Conclusão: As informações obtidas nesta pesquisa indicam que os dados epidemiológicos desempenham papel crucial no que diz respeito à aplicação de novos recursos, tecnologias e tratamentos. Tais conhecimentos permitirão desenvolver estratégias e condutas direcionadas à qualidade na assistência intensiva.

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Epidemiology of severe infections in Latin American intensive care units

Cited by 8 publications

References 19 publications

Sensitivity analysis–based sepsis prognosis using artificial intelligence

Sensitivity analysis–based sepsis prognosis using artificial intelligence

The practice of intensive care in Latin America: a survey of academic intensivists

Características epidemiológicas de pacientes com sepse em unidade de terapia intensiva

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