Management of severe sepsis in patients admitted to Asian intensive care units: prospective cohort study

Phua, Jason; Koh, Younsuck; Du, Bin; Tang, Ya‐Bin; Divatia, Jigeeshu V.; Tan, Cheng Cheng; Gomersall, Charles D; Faruq, Mohammad Omar; Shrestha, Babu Raja; Binh, Nguyen Gia; Arabi, Yaseen M.; Salahuddin, Nawal; Wahyuprajitno, Bambang; Tu, Mei-Lien; Wahab, Ahmad Yazid Haji Abd; Hameed, Akmal A.; Nishimura, Masaji; Procyshyn, Mark; Chan, Yiong Huak

doi:10.1136/bmj.d3245

Cited by 203 publications

(186 citation statements)

References 38 publications

(72 reference statements)

Supporting

Mentioning

152

Contrasting

Unclassified

Order By: Relevance

“…A multicenter observational study conducted from September 2007 to October 2008 in 11 ICUs of Chinese teaching hospitals showed that the overall compliance during 6 h resuscitation and 24 h management bundles were 5.5% and 17.4%, respectively (20). Another study conducted in 150 ICUs in 16 Asian countries in July 2009 showed similar results (21). Currently, we can access all the advanced information from literature and scientific proceedings; however, the basic knowledge and skill training courses are inadequate.…”

Section: Mortality Of Sepsissupporting

confidence: 61%

Current epidemiology of sepsis in mainland China

Liao

et al. 2016

Ann. Transl. Med.

View full text Add to dashboard Cite

The disease burden of sepsis is a global issue. Most of the large-scale epidemiological investigations on sepsis have been carried out in developed countries. The population of 1.3 billion in mainland China accounts for approximately 1/5 th of the whole world population. Thus, the knowledge of the incidence and mortality of sepsis in mainland China is vital before employing measures for its improvement. However, most of the epidemiological data of sepsis in mainland China was obtained from ICU settings, and thus lacks the population-based incidence and mortality of sepsis. In the present review, we summarized the limited literature encompassing the incidence, mortality, long-term outcome, and pathogens of sepsis in mainland China. Therefore, it might provide some valuable information regarding the sepsis disease burden and current issues in the management of sepsis in mainland China.

show abstract

Section: Mortality Of Sepsissupporting

confidence: 61%

Current epidemiology of sepsis in mainland China

Liao

et al. 2016

Ann. Transl. Med.

View full text Add to dashboard Cite

show abstract

“…14 MOSAICS study in medical ICUs of Asian countries reported a mortality of 44.5%. 15 A prospective study by INDICAP in Indian medical ICUs also reported a high mortality in different parts of the country. 16 Our study reported a mortality of 11.5% and 11.2% were transferred to palliative care/ transferred to other hospitals.…”

Section: Discussionmentioning

confidence: 99%

Clinical profile, bacterial profile and outcomes in an intensive care unit of a tertiary care hospital in south India: one year study

Sarvepalli

Dharana

2017

Int J Adv Med

View full text Add to dashboard Cite

Prevalence of ICU infections varies between 45% to 58% 10 and incidence rates between 30 to 35%. 11,12 Factors associated with increased risk of infections in ICU are ABSTRACT Background: Infections still remain as one of the major cause of mortality in low and lower-middle-income countries as reported by Global Burden of Diseases study. Intensive care units (ICU) are a major source of infections in tertiary care hospitals. Widespread multi-drug resistant gram positive and gram negative bacterial isolates are also associated with infections in ICU. A hospital based epidemiological study was to determine the risk factors; bacterial isolates, antibiotic sensitivity and outcomes in ICU patients. Methods: This prospective study was done at Narayana Medical College and Hospital for 12 months from 1 st February 2015 to 31 st January 2016. All the risk factors were noted. Patient's outcome noted as death, recovery and transfer to palliative care. Data entry and analysis performed in Microsoft excel, p valve < 0.001 was considered significant. Results: Three hundred and thirty patients were included in the study (age: 56.16±15 years, 57.6% males). 159 (48.2%) were direct admissions, 103 (31.2%) were transfers from other hospitals. Major cause of admission was neural (29.1%) followed by cardiovascular (21.8%). HTN (52.4%) was major co-morbidity followed by type-2 DM (47.3%). 51.9% culture positivity (n = 539) was observed with sputum 83.6% and blood 24.2%. Gram-negative pathogens were predominant which includes Acinetobacter baumanii (13.8%), Escherichia coli (20%), Klebsiella pneumoniae (14.3%), Pseudomonas aeruginosa (9%), Enterobacter aerogenes (5.1%). Candida Sp and MRSA, VRE were isolated. In the study 255(77.3%) recovered, 38(11.5%) progressed to death and 37(11.2%) transferred to palliative care. Higher mortality was noticed with Acinetobacter baumani (81.6%). Conclusions: High prevalence of gram-negative bacterial infections and multi-drug resistant isolates was noted in Indian ICUs. Sarvepalli AK et al. Int J Adv Med. 2017 Feb;4(1):156-161 International Journal of Advances in Medicine | January-February 2017 | Vol 4 | Issue 1 Page 157 intrinsic risk factors associated with the patient, invasive medical devices, overcrowding and animate objects which act as reservoirs for bacterial isolates. Higher incidence and prevalence of infections in ICU are associated with higher age, higher APACHE-2 score (Acute physiology and chronic health evaluation) and associated co morbid conditions. Widespread multi-drug resistant gram positive and gram negative bacterial isolates are also associated with infections in ICU. Reports on the emergence of metallo β-lactamase (MBL) and carbapenemase-producing gram negative bacterial isolates, methicillin-resistant Staphylococcus aureus (MRSA), Vancomycin-resistant enterococci (VRE) are posing a serious threat in outcomes of patients in ICU. KeywordsThe present study was sought to determine the prevalence of infections, clinical risk factors, bacterial isolates and antibiotic profil...

show abstract

“…Poor clinical outcomes are related to many factors including patient factors such as malnutrition, lack of readily available resources to appropriately triage, diagnose and treat sepsis, and suboptimal adherence to specific sepsis management guidelines (3)(4)(5)(6)(7)(8)(9). Even as evidence-based protocols directed at managing sepsis in resource dense and resource poor environments have emerged, the promise of reduced mortality has been difficult to realize (10)(11)(12)(13)(14).…”

Section: Introductionmentioning

confidence: 99%