Prevalence and outcome of sepsis in respiratory intensive care unit

Abstract

Background Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Objective To assess the prevalence and outcome of sepsis in RICU Patients and methods The study was conducted upon 403 patients admitted at RICU of the Abbassia Chest Hospital, Cairo, Egypt; 100 of them had sepsis either on admission or acquired in the RICU during the period from May 2019 to November 2019. Severity of illness was assessed by Acute Physiology and Chronic Health Evaluation II (APACHE II score), which was recorded within 24 h from patient admission. Quick sepsis-related organ failure assessment (qSOFA) score was recorded in emergency room, and sepsis-related organ failure assessment (SOFA) score was recorded on ICU admission and on the 3rd and 7th day of ICU stay. Type of infection (community or hospital acquired), infection site, and pathogenic organisms, all were recorded. Assessment was done also regarding mechanical ventilation, length of RICU stay, the presence of comorbidities, survived patients, and dead ones, as regards causes of death and risk factors. Results The study included 100 cases with sepsis out of 403 admitted cases in the same duration with frequency 24%. Among sepsis patients, 72% were males and 28%were females, with mean age 51.62 ± 18.62 years. The main diagnosis was pneumonia (62%), and the main comorbidity was diabetes mellitus (23%). There was significant increase in age among non-survivors when compared with survivors. There was significant increase in number of mechanically ventilated patients and a highly significant incidence of complications and need for vasoactive drugs among non-survivors when compared with survivors. There was a highly significant higher APACHE II score on the 1st day of admission among non-survivor patients. The SOFA score was significantly higher on the 1st day of admission and significantly higher on the 3rd and 7th day of admission among non-survivor patients when compared to survived patients. Conclusion The current study showed that sepsis affects nearly one quarter of cases admitted at RICU, and it is usually associated with higher mortality rate in those patients. Trial registration ClinicalTrials.gov NCT05240157. Registered February 15, 2022. Retrospectively registered.

Sepsis among Adults Admitted to Intensive Care Unit of a Tertiary Care Centre

“…Another study conducted in Ethiopia reported an overall prevalence of sepsis and septic shock at 26.5%, 3 while in Egypt, it was 24.8%. 4 In a Colombian city, the prevalence was found to be 44%, 6 and in Jordan, it was 23.3%. 7 The differences in the prevalence were due to differences in setting, differences in the diagnostic criteria used and population.…”

“…The presence of infection and organ dysfunction was consistent with the findings of other significant studies (24.8-40%), including the Worldwide Data from the Intensive Care Over Nations Audit and Sepsis Occurrence in Acutely Ill Patients (SOAP). 4 , 5 , 8 According to the 2017 Global Burden of Disease Study, 48.9 million cases of sepsis occurred worldwide, with 11 million deaths, accounting for 19.7% of all global deaths. 9 This study underlines the immense impact of sepsis on modern ICUs.…”

“… 5 We believe this disparity is related to variations in ICU admissions and causes among enrolled patients since our patients carried substantial infection burdens. 4 …”

“… 3 A staggering 8-26% of deaths result from these conditions, along with increased treatment costs. 4 …”

“…Sepsis in intensive care unit (ICU) patients is well documented in developed countries, 4 but there is limited data in low- and middle-income countries. Nevertheless, these data help increase awareness of sepsis, identify more effective preventive and therapeutic interventions, and guide resource allocation.…”