Epidemiology of sepsis and risk factors for mortality in intensive care unit: a hospital based prospective study in South India

Garg, Rahul; Tellapragada, Chaitanya; Shaw, Tushar; Eshwara, Vandana Kalwaje; Shanbhag, Vishal; Rao, Shwethapriya; Virk, Harjeet Singh; Varma, Muralidhar; Mukhopadhyay, Chiranjay

doi:10.1080/23744235.2021.2017475

Cited by 5 publications

(4 citation statements)

References 30 publications

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“…Conversely, in an ICU in southern India, male sex had a higher mortality risk. 19 Moreover, we detected an association between prolonged length of stay and mortality, which is consistent with a previous study that analyzed risk factors for mortality in VAE in ICU patients in which prolonged hospital stay was an independent risk factor for mortality in multivariate analysis. 20 Furthermore, we identified an association between invasive mechanical ventilation utilization ratio and increased mortality risk.…”

Section: Discussionsupporting

confidence: 91%

Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections

Rosenthal

Jin

Rodrigues

et al. 2022

Infect. Control Hosp. Epidemiol.

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Objective: To identify risk factors for mortality in intensive care units (ICUs) in Asia. Design: Prospective cohort study. Setting: The study included 317 ICUs of 96 hospitals in 44 cities in 9 countries of Asia: China, India, Malaysia, Mongolia, Nepal, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam. Participants: Patients aged >18 years admitted to ICUs. Results: In total, 157,667 patients were followed during 957,517 patient days, and 8,157 HAIs occurred. In multiple logistic regression, the following variables were associated with an increased mortality risk: central-line–associated bloodstream infection (CLABSI; aOR, 2.36; P < .0001), ventilator-associated event (VAE; aOR, 1.51; P < .0001), catheter-associated urinary tract infection (CAUTI; aOR, 1.04; P < .0001), and female sex (aOR, 1.06; P < .0001). Older age increased mortality risk by 1% per year (aOR, 1.01; P < .0001). Length of stay (LOS) increased mortality risk by 1% per bed day (aOR, 1.01; P < .0001). Central-line days increased mortality risk by 2% per central-line day (aOR, 1.02; P < .0001). Urinary catheter days increased mortality risk by 4% per urinary catheter day (aOR, 1.04; P < .0001). The highest mortality risks were associated with mechanical ventilation utilization ratio (aOR, 12.48; P < .0001), upper middle-income country (aOR, 1.09; P = .033), surgical hospitalization (aOR, 2.17; P < .0001), pediatric oncology ICU (aOR, 9.90; P < .0001), and adult oncology ICU (aOR, 4.52; P < .0001). Patients at university hospitals had the lowest mortality risk (aOR, 0.61; P < .0001). Conclusions: Some variables associated with an increased mortality risk are unlikely to change, such as age, sex, national economy, hospitalization type, and ICU type. Some other variables can be modified, such as LOS, central-line use, urinary catheter use, and mechanical ventilation as well as and acquisition of CLABSI, VAE, or CAUTI. To reduce mortality risk, we shall focus on strategies to reduce LOS; strategies to reduce central-line, urinary catheter, and mechanical ventilation use; and HAI prevention recommendations.

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Section: Discussionsupporting

confidence: 91%

Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections

Rosenthal

Jin

Rodrigues

et al. 2022

Infect. Control Hosp. Epidemiol.

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“…Por outro lado, pesquisa com indianos estabeleceu que 53,5% dos casos tiveram etiologia bacteriana como responsável pela sepse, sendo os microrganismos multidroga-resistentes (MDR) responsáveis por 24%. Dos 37% dos casos que foram isolados Gramnegativos, foi encontrada resistência aos carbapenêmicos, sendo a Escherichia coli responsável por 34,1% das contaminações (Garg et al, 2022).…”

Section: Resultsunclassified

Perfil clínico e preditores de mortalidade intra-hospitalar em adultos criticamente doentes com sepse: revisão integrativa

Cruz

Silva

et al. 2022

RSD

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A sepse constitui uma importante causa de morte em pacientes com infecção, tendo impacto substancial na saúde em todo o mundo. A utilização de preditores de mortalidade intra-hospitalar torna-se uma alternativa para o tratamento dos pacientes adultos criticamente doentes com sepse, pois essa desempenha importantes funções diagnósticas, terapêuticas e prognósticas, diminuindo os óbitos nas unidades de terapia intensiva. Dessa forma, o presente estudo objetivou identificar na literatura os principais preditores de prognóstico e perfil clínico para mortalidade em pacientes adultos internados em Unidades de Terapia Intensiva (UTI) com sepse. As buscas foram realizadas nos periódicos eletrônicos Medline/Pubmed, Scopus, Web of Science e LILACS, a partir de estudos publicados entre os anos de 2017 a 2022, por meio da utilização da questão norteadora: Quais os principais preditores de prognóstico e perfil clínico para mortalidade por sepse apresentados em pacientes adultos internados em Unidades de Terapia Intensiva (UTI)? Um total de 18 publicações foram incluídas nesta revisão, que identificou a presença de idade avançada, comorbidades, infeções por bactérias resistentes aos antibióticos, tempo de internação prolongado e uso de procedimentos ou equipamentos invasivos como perfil clínico e variáveis predisponentes para maior mortalidade por sepse. Portanto, os profissionais da saúde devem conhecer os impactos comuns do uso desses preditores em pacientes vítimas de sepse em unidade de terapia intensiva, minimizando maiores percentuais de óbito na população e aparecimento de sequelas posteriores ao tratamento, ajudando a orientar uma assistência de qualidade com base em evidências cientificas.

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“…Finally, we want to emphasize that our findings are consistent with the literature regarding the relationship between HTN and adverse outcomes in sepsis patients since non-survivors showed a higher frequency of HTN. A recent study by Garg et al showed that male gender, HTN, SOFA > 9, and increased creatinine were predictors for mortality in adult patients with diagnosis of sepsis requiring ICU care 42 . Moreover, it appears that HTN, along with other chronic medical conditions, might increase the risk of incident sepsis episodes 43 .…”

Section: B Amentioning

confidence: 99%

Simplified acute physiology score II and Mannheim peritonitis index are associated with in-hospital mortality in patients with abdominal sepsis admitted to ICU

Sánchez-Díaz¹,

Escarraman-Martínez²,

Guerrero-Gutiérrez³

et al. 2022

CIRU

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Objective:The objective of this study was to assess the association and interaction of laboratory parameters, Simplified Acute Physiology Score II (SAPSII), Modified Shock Index (MSI), and Mannheim Peritonitis Index (MPI) with in-hospital mortality. Material and methods:We conducted a single-center case-control study. Adult patients with abdominal sepsis were included from May 2015 to May 2020. Baseline characteristics, laboratory parameters, SAPSII, MSI, and MPI scores at admission were collected. A principal component (PC) analysis was applied to evaluate variable interactions. In-hospital mortality risk was determined through logistic regression models. Results: One hundred and twenty-seven patients were identified, 60 of which were included for analyses. Non-survivors (48.4%) had a higher frequency of hypertension, lactate and MPI, and lower BE and alactic BE levels. Eight PCs were obtained, PC1 being a linear combination of pH,

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Epidemiology of sepsis and risk factors for mortality in intensive care unit: a hospital based prospective study in South India

Cited by 5 publications

References 30 publications

Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections

Risk factors for mortality over 18 years in 317 ICUs in 9 Asian countries: The impact of healthcare-associated infections

Perfil clínico e preditores de mortalidade intra-hospitalar em adultos criticamente doentes com sepse: revisão integrativa

Simplified acute physiology score II and Mannheim peritonitis index are associated with in-hospital mortality in patients with abdominal sepsis admitted to ICU

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