Clinical profile and outcome of patients with severe sepsis treated in an intensive care unit in India

Paary, T T S; Kalaiselvan, M S; Renuka, M; Arunkumar, A S

doi:10.4038/cmj.v61i4.8386

Cited by 14 publications

(15 citation statements)

References 9 publications

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“…This may indicate that the intensity of the illness was severe in this cohort of the patients on presentation to the ICU. This was comparable to the severity of illness scores reported in many recently reported sepsis trials where admission SOFA scores ranged from 2 (United Kingdom) to 8 (Japan, India) and APACHE II scores ranged from 15 (Australia) to 21 (United States) [7,[16][17][18][19].…”

Section: Discussionsupporting

confidence: 84%

“…Stevenson et al using control arm data from randomized clinical trials showed a mortality rate of up to 30% for severe sepsis [4]. In developing and low-resource countries, which may not have been represented by trial data, the mortality rate for sepsis is even higher, with an almost 50% mortality rate being reported for severe sepsis and septic shock in developing and resource-poor countries [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean

Singh

Subramanian

Ventour

et al. 2020

Cureus

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To investigate the epidemiology, management, and predictors of mortality in severe sepsis and septic shock in the intensive care units (ICUs) of Trinidad, Trinidad & Tobago. Methods A prospective observational study in four ICUs over a one-year period (August 2017-August 2018) was conducted. Physiologic variables, treatment data, and outcomes were collected on admission to ICU and daily until 28 days. The 28-day mortality and ICU mortality were recorded. Subgroup analysis was performed based on survival, and predictors of mortality were determined through logistic regression. Results Outcome data were available for 163 patients. The 28-day mortality rates for sepsis and septic shock were 42% and 47%, respectively. ICU mortality rate for sepsis was 34%. The most common suspected source of infection was pneumonia (33%). Acute kidney injury (AKI) was common and present in 71% of patients, with renal replacement therapy only being used in 30% of cases. Mechanical ventilation was required in 84% of cases. Moderate-to-severe acute respiratory distress syndrome (ARDS) (OR: 4; 95% CI: 1.9-8.8; p < 0.001) and the development of AKI (all stages) (OR: 10; 95% CI: 3.9-30.2; p < 0.001) were found to be predictive of mortality. Incidence of mechanical ventilation, moderate-to-severe ARDS, stage 3 AKI, septic shock, and failure to achieve a mean arterial pressure of > 60 mmHg within the first 24 hours of admission were higher in patients who did not survive (p < 0.05). Conclusions Sepsis and septic shock are associated with a high 28-day mortality. Organ dysfunction with renal and pulmonary involvement was an important factor in predicting a higher mortality.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean

Singh

Subramanian

Ventour

et al. 2020

Cureus

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“…These results reinforce previous findings that sepsis is a condition associated with increased morbidity and mortality. ( 30 )…”

Section: Discussionmentioning

confidence: 99%

Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study

Martins

Silveira

Viégas

et al. 2019

Revista Brasileira De Terapia Intensiva

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Objective To evaluate the neutrophil-lymphocyte ratio as a predictor of sepsis and mortality in patients admitted to an intensive care unit. Methods Case-control study of adult patients admitted to an intensive care unit. Patients who had sepsis as the reason for admission and who had a previous complete blood count examination were included as case patients. The following statistical analyses were performed: ROC curves, binary logistic regression, and Mann-Whitney and Pearson's chi-square tests. p < 0.05 was considered significant. Results The ROC curve values were 0.62 for neutrophil-lymphocyte ratio, 0.98 for band neutrophils and 0.51 for total leukocytes. The presence of a neutrophil-lymphocyte ratio greater than 5.0, leukocyte count above 12,000mm 3 /mL and band neutrophil percentage above 10% were risk factors for sepsis; however, only the SAPS 3 and SOFA score were related to patient mortality. Conclusion The neutrophil-lymphocyte ratio and band neutrophils in combination with other parameters may be markers for the early detection of sepsis in intensive care units.

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“…Paary TTS et al, and Todi et al, had found 64.2% and 57.71% of male patients respectively in their studies which is similar to our study. 18,19 Fever was the most common presenting symptom in all cases followed by altered sensorium, cough and dyspnoea in 52, 44 and 43 cases respectively. Bhattacharyya et al also observed fever as the predominant symptoms in their study.…”

Section: Discussionmentioning

confidence: 95%

“…TTS Paary et al, had similar observation with source of infection in the respiratory tract (37.2%), whereas Simon F et al, Engel C et al, Karlsson S et al, and Desai SR et al, showed different source of infections. 8,18,[20][21][22] Mortality was highest in pneumonia with 20 (55.55%), followed by malaria with 10 (52.63%) and lowest in UTI with 2 (10.52%). Fedili U et al, also observed respiratory tract infection as the commonest (40%) cause of mortality like our study, whereas Leligdowicz A et al, reported ischemic bowel as the highest (75%) cause of mortality among severe sepsis cases.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and outcome of organ dysfunction in sepsis

et al. 2018

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Background: Sepsis is defined as life threatening organ dysfunction due to a dysregulated host response to infection. It is the tenth leading cause of death among older adults in United States. Mortality rate of the sepsis ranges from 30-40%. In severe cases sepsis can drastically reduce blood flow to the major organs, leading eventually to septic shock, widespread organ failure and death. So, the present study was done to evaluate the clinical profile, symptoms, source of infection, co-morbid conditions and outcome with respect to the organ dysfunction in sepsis cases.Methods: This prospective observational study was undertaken among 100 cases of sepsis diagnosed by the “International Sepsis Definitions Conference” criteria admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for laboratory investigations.Results: In present study, a total of 100 cases were enrolled. Mean age of cases were 38.15 years. Male and female ratio was 1.63:1. Most common symptom was fever (100%). Pneumonia was the most common (36%) source of infection. Mortality was highest in pneumonia (55.55%). 77 % of cases had organ dysfunction. Cardiovascular system was the most common system involved. Maximum mortality was within the age group of 56-65 years. Diabetes was the most common co-morbid condition. Mean APACHE II score was high among the death cases.Conclusions: Sepsis was more common in younger group of patients but mortality was more in elderly age group. Overall mortality was 38%.

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Clinical profile and outcome of patients with severe sepsis treated in an intensive care unit in India

Cited by 14 publications

References 9 publications

Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean

Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean

Neutrophil-lymphocyte ratio in the early diagnosis of sepsis in an intensive care unit: a case-control study

Clinical profile and outcome of organ dysfunction in sepsis

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