Incidence of sepsis in hospitalized patients

Moreno, Rui P.; Afonso, Susana; Fevereiro, Teresa

doi:10.1007/s11908-006-0044-2

Cited by 18 publications

(11 citation statements)

References 64 publications

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“…Sepsis, defined as the systemic reaction to infection [1], remains an important cause of morbidity and mortality in ICUS worldwide [16][17][18]. Despite the development of new therapies and integrated approaches for diagnosis and care of the patient with sepsis [19], mortality remains high [17].…”

Section: Discussionmentioning

confidence: 99%

Sepsis mortality prediction based on predisposition, infection and response

et al. 2007

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Objective: To empirically test, based on a large multicenter, multinational database, whether a modified PIRO (predisposition, insult, response, and organ dysfunction) concept could be applied to predict mortality in patients with infection and sepsis. Design: Substudy of a multicenter multinational cohort study (SAPS 3). Patients: A total of 2,628 patients with signs of infection or sepsis who stayed in the ICU for > 48 h. Three boxes of variables were defined, according to the PIRO concept. Box 1 (Predisposition) contained information about the patient's condition before ICU admission. Box 2 (Injury) contained information about the infection at ICU admission. Box 3 (Response) was defined as the response to the infection, expressed as a Sequential Organ Failure Assessment score after 48 h. Interventions: None. Main measurements and results: Most of the infections were community acquired (59.6%); 32.5% were hospital acquired. The median age of the patients was 65 (50-75) years, and 41.1% were female. About 22% (n = 576) of the patients presented with infection only, 36.3% (n = 953) with signs of sepsis, 23.6% (n = 619) with severe sepsis, and 18.3% (n = 480) with septic shock. Hospital mortality was 40.6% overall, greater in those with septic shock (52.5%) than in those with infection (34.7%). Several factors related to predisposition, infection and response were associated with hospital mortality. Conclusion: The proposed three-level system, by using objectively defined criteria for risk of mortality in sepsis, could be used by physicians to stratify patients at ICU admission or shortly thereafter, contributing to a better selection of management according to the risk of death.

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Section: Discussionmentioning

confidence: 99%

Sepsis mortality prediction based on predisposition, infection and response

et al. 2007

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“…Among these 554 patients, we recorded sepsis in 30 (2.5%), severe sepsis in 269 (22.8%), and septic shock in 255 (21.6%) (Figure 1). The median APACHE II score was 13 (10-18) for patients without SIRS; 16 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23) …”

Section: Resultsmentioning

confidence: 99%

“…10 Additional studies showed that the incidence and mortality of sepsis in Brazilians admitted to the ICU are among the highest in the world. 6,11 Understanding the reasons for the elevated incidence of sepsis in Brazil is the fi rst step to improving prevention, diagnosis, and care of septic patients in this country.…”

Section: Introductionmentioning

confidence: 99%

The epidemiology of sepsis in a Brazilian teaching hospital

Kauss¹,

Grion²,

Cardoso³

et al. 2010

Braz J Infect Dis

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We declare no confl ict of interest. ABSTRACT Objectives:The objective of this study was to estimate disease incidence and mortality rate of sepsis in a tertiary public hospital. Methods: Patients admitted to the Intensive Care Unit (ICU) in 2004 and 2005 were monitored for sepsis using an observational longitudinal study design. Patients were monitored daily for diagnostic criteria of sepsis, according to ACCP/SCCM Consensus Conference criteria, until either death or hospital discharge. Results: During the study, we analyzed 1,179 patients. Systemic Infl ammatory Response Syndrome (SIRS) was present in 1,048 (88.9%) patients on admission, and was associated with infection in 554 (47.0%) patients. Of these, sepsis was diagnosed in 30 (2.5%) patients, while severe sepsis was diagnosed in 269 (22.8%) patients, and septic shock was diagnosed in 255 (21.6%) patients. APACHE II and SOFA scores were higher in septic patients (p < 0.001), and the ensuing mortality rates were 32.8% (IC 95%: 21.6-45.7%) for patients with sepsis, 49.9% (IC 95%: 44.5-55.2%) for severe sepsis, and 72.7% (IC 95%: 68.1-76.9%) for septic shock. Conclusions: The data from our study revealed a high incidence of sepsis among hospitalized patients. Moreover, sepsis patients had a high rate of mortality.

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“…La incidencia de bacteriemia en la población general se ha incrementado en las últimas décadas y, además, a pesar de los avances médicos, la mortalidad asociada sigue siendo elevada 1,2 . En el análisis epidemiológico de los pacientes con bacteriemia en un hospital general universitario de tercer nivel hemos de considerar que los microorganismos están tratados mediante una mayor presión antibiótica y el espectro de resistencias es potencialmente mayor 3 .…”

Section: Introductionunclassified

Influencia en la evolución de los pacientes con bacteriemia/candidemia de la participación activa del especialista clínico en Patología Infecciosa. Estudio de una cohorte prospectiva

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Torres

Gómez

et al. 2017

Infect

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Influencia en la evolución de los pacientes con bacteriemia/candidemia de la participación activa del especialista clínico en Patología Infecciosa. Estudio de una cohorte prospectiva ARTÍCULO ResumenIntroducción: Nuestro objetivo es evaluar el impacto de la participación activa del especialista en Patología Infecciosa en el pronóstico de los enfermos con bacteriemia/candidemia. Pacientes y métodos: Estudio observacional, longitudinal y prospectivo de una cohorte de pacientes con bacteriemia/candidemia en un hospital de tercer nivel (2010)(2011). Se analizaron los factores asociados con fracaso terapéutico (persistencia de la bacteriemia/candidemia o muerte relacionada) mediante análisis bivariante y multivariante. Resultados: Se valoraron un total de 324 episodios de bacteriemia/candidemia significativa, de los que en 252 pacientes (78%) el Servicio de Medicina Interna Infecciosas aplicó un sistema de participación activa (recomendación sobre el tratamiento antibiótico). La adquisición de la bacteriemia se consideró nosocomial o relacionada con cuidados sanitarios en 154 pacientes (47,5%) y comunitaria en 170 (52,5%). Los focos de infección más frecuentemente identificados fueron: urinario (31%), catéter vascular (14%), intraabdominal (12%) y desconocido (15%). El 31,6% era portador de sonda vesical y el 35,4%, de catéter venoso central. El 24% de los pacientes no presentaban fiebre (>38 °C) en el momento de cursar los hemocultivos. La bacteriemia fue persistente en 35 pacientes (11%). La mortalidad global fue del 17,4% y del 15% relacionada («fracaso» terapéutico, 20%). Se asociaron a un mayor fracaso terapéutico el índice de Pitt ≥ 3 (OR 7,94), McCabe III (OR 3,11), uso previo de antibióticos (OR 2,93) y la ausencia de participación activa de los especialistas clínicos en Patología Infecciosa (OR 2,44). Conclusiones: En la cohorte de pacientes con bacteriemia/candidemia estudiada, la gravedad de la enfermedad de base, la gravedad al inicio, el uso previo de antibióticos y la ausencia de participación activa de los especialistas clínicos en Patología Infecciosa se asociaron a fracaso terapéutico. Palabras clave: Pronóstico; Bacteriemia; Consultor de enfermedades infecciosasThe impact of Infectious Disease specialist active care on the outcome of patients with bacteraemia/candidemia. A prospective cohort study Abstract Introduction: Our objective is to evaluate the impact of active care by an Infectious Diseases specialist (IDS) on the outcome of patients with bacteraemia/candidemia. Patients and methods: Observational, longitudinal and prospective study of a cohort of patients with bacteraemia/candidemia in a tertiary level hospital (2010)(2011). Factors associated with treatment failure (persistent bacteraemia or related death) were analysed (bivariate and multivariate analysis).Results: A total of 324 episodes of bacteraemia were included, of which surveillance by IDS was implemented in 252 cases (78%). Acquisition was considered nosocomial or healthcare-related in 154 patients (47.5%) and community acquir...

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Incidence of sepsis in hospitalized patients

Cited by 18 publications

References 64 publications

Sepsis mortality prediction based on predisposition, infection and response

Sepsis mortality prediction based on predisposition, infection and response

The epidemiology of sepsis in a Brazilian teaching hospital

Influencia en la evolución de los pacientes con bacteriemia/candidemia de la participación activa del especialista clínico en Patología Infecciosa. Estudio de una cohorte prospectiva

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