Sepsis: a private hospital experience in Nepal

Lakhey, Sanjay; Karki, B; Shrestha, B; Shakya, Siddhartha; Pandey, Shivani

doi:10.3126/joim.v28i1.428

Cited by 8 publications

(9 citation statements)

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“…The factors associated with mortality are compared among survivors and non-survivors in table 2. 12 This study showed a mortality of 30.9% in contrast to the study by Lakhe S et al 12 The difference in mortality may represent a population which is from different geographical region and different ICU admission criteria.…”

Section: Resultscontrasting

confidence: 59%

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Serum Lactate Level as a Predictor of Outcome in Patients with Septic Shock

Bhandari

Paudel

Malla

2019

Jnl. BP Koirala Inst. Health Sci.

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Background: Sepsis and Septic shock are a common presentation in the Emergency Department with high morbidity and mortality. Serum lactate level increases substantially in the patients with septic shock. The objectives of this study were to determine serum lactate levels at the time of presentation, find out the outcome and correlate lactate levels with the outcome in the patients with septic shock. Methods:It is a prospective cross-sectional study of patients presenting to the Emergency, who met the criteria for septic shock defined by Surviving Sepsis Guidelines 2012. Patients' demographics, comorbidity, triage vitals, laboratory and radiological parameters were recorded. The primary outcome was mortality and secondary outcomes were duration of stay in hospital and complications, if any, developed during hospital stay.Results: Eighty-four cases were enrolled, with male to female ratio of 1:1. Mean age was 46.40 19.59 years. The significant variables were: serum lactate (p<0.001), pH level (p= 0.001), serum creatinine (p= 0.002) and INR level (p= 0.001). Serum lactate was the significant factor that correlated with mortality after applying multivariate regression analysis (OR= 2.75, CI= 0.890-4.041, p= 0.001). Conclusion:Initial serum lactate level is independently associated with mortality of the patients presenting to ED with septic shock.

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Section: Resultscontrasting

confidence: 59%

“…Another multicentric prospective observational study from India by Todi S et al 13 M: F ratio of 1:1 in our study was almost similar in most studies. 8,10,12,15,17 Mean MAP in this study was 54.84 ± 8.28 mmHg. Most other studies show higher MAP ranging from 68 to 77 mmHg.…”

Section: Resultsmentioning

confidence: 50%

Serum Lactate Level as a Predictor of Outcome in Patients with Septic Shock

Bhandari

Paudel

Malla

2019

Jnl. BP Koirala Inst. Health Sci.

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“…Severe sepsis and sep c shock has been recognized to have a high risk of death with high mortality rate of 20-30% with overall hospital death of [2][3][4] 30-50%. Similarly mortality rate of sepsis in Nepal found to 5,6 be 40%, so sepsis is s ll the leading cause of death. Furthermore majority of those who survives a er the diagnosis of severe sepsis have poor quality of life who frequently develop cogni ve and func onal disability [7][8][9] require substan al ongoing acute and long-term care.…”

Section: Introductionmentioning

confidence: 97%

Serum Lactate Albumin Ratio as a Predictor of Mortality in Severe Sepsis and Septic Shock at Tribhuwan University Teaching Hospital, Kathmandu

Thapa

Prasad

Shakya

2017

Birat J. Health Sci.

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IntroductionSevere sepsis and septic shock, is a common cause of emergency room admission and is associated with high morbidity and mortality worldwide. This study inspects the prediction of mortality in severe sepsis and septic shock with increased lactate/albumin ratio.Objective The objective of the study was to predict the serum lactate albumin ratio as an indicator of mortality in severe sepsis and septic shock.MethodologyIt was a hospital based cross sectional study done at Tribhuvan University Teaching Hospital, Kathmandu from November 2015 to October 2016. The consent was taken from patients. Acute Physiology and Chronic Health Evaluation II score, serum lactate and serum albumin levels on first day of arrival in emergency room were calculated. Patients were classified as severe sepsis and septic shock and treated according to Surviving Sepsis Campaign 2012 guideline. The patient were follow up at 28 day, The associations of 28-day outcome with Acute Physiology and Chronic Health Evaluation II score, serum lactate value, serum albumin value and serum lactate albumin ratio value were derived.ResultsOut of total 240 severe sepsis and septic shock patients it is found that increased serum lactate/albumin ratio was an independent predictor of the mortality with cut off value of 0.07. Furthermore serum lactate albumin ratio shows strong correlation with APACHE 2 score in predicting mortality in severe sepsis and septic shock.ConclusionIncreased lactate/albumin ratio predicts mortality in patients with severe sepsis and septic shock. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 191-195

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“…Sejumlah faktor yang menyebabkan terjadinya peningkatan insidensi sepsis tersebut adalah bertambahnya kemampuan dalam mendiagnosis sepsis, penggunaan alatalat yang invasif seperti kateter vena sentral, dan peningkatan kejadian HIV/AIDS. 3,4 Insidensi sepsis di Indonesia khususnya di Jawa Barat belum diketahui dengan jelas. Penelitian Friedland dkk.…”

Section: Pendahuluanunclassified

Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, dan D-dimer Sebagai Prediktor Decompensated Disseminated Intravascular Coagulation Sisseminated pada Sepsis

Fenny¹,

Dalimoenthe²,

Noormartany³

et al. 2011

mkb

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AbstrakSepsis adalah respons sistemik terhadap infeksi dan terutama terjadi pada pneumonia. Sepsis dapat menyebabkan komplikasi disseminated intravascular coagulation (DIC) yang dibedakan menjadi compensated dan decompensated DIC. Tujuan penelitian ini adalah untuk menentukan apakah nilai prothrombin time (PT), activated partial thromboplastin time (aPTT), kadar fibrinogen, dan D-dimer dapat digunakan sebagai prediktor decompensated DIC pada penderita sepsis. Penelitian dilakukan di Laboratorium Patologi Klinik Rumah Sakit Hasan Sadikin Bandung mulai September 2008 sampai Juni 2010. Subjek penelitian adalah penderita sepsis yang disebabkan pneumonia. Nilai PT, aPTT, kadar fibrinogen, dan D-dimer semua subjek sepsis dicatat kemudian dilakukan pengamatan sampai subjek dinyatakan mengalami decompensated atau non-decompensated DIC; selanjutnya dilakukan analisis nilai PT, aPTT, kadar fibrinogen, dan D-dimer pada kelompok decompensated dan non-decompensated DIC. Penelitian menggunakan rancangan cohort. Subjek berjumlah 39 orang (58%) penderita sepsis dengan luaran decompensated DIC dan 28 orang (42%) penderita sepsis dengan luaran non-decompensated DIC. Dari parameter hemostasis yang diperiksa, didapatkan bahwa nilai PT, aPTT, dan fibrinogen merupakan prediktor decompensated DIC pada penderita sepsis dengan risiko relatif (RR) masing-masing 240,500; 7,157; dan 6,421. Simpulan, prothrombin time, aPTT, dan fibrinogen merupakan pemeriksaan untuk mengetahui aktivasi koagulasi. Parameter hemostasis yang merupakan prediktor decompensated DIC pada penderita sepsis adalah nilai PT dan aPTT yang memendek serta kadar fibrinogen yang meningkat. -dimer as a Predictor of Decompensated Disseminated Intravascular Coagulation in Sepsis AbstractSepsis is a systemic response to infection especially in pneumonia case. Sepsis can cause complications such as disseminated intravascular coagulation (DIC) which can be divided into compensated and decompensated DIC. The purpose of this study was to assess whether the value of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer levels can be used as predictors of decompensated DIC in sepsis patients. This study was conducted at the Laboratory of Clinical Pathology Rumah Sakit Hasan Sadikin Bandung since September 2008 to June 2010. Subjects were patients with sepsis caused by pneumonia. PT and aPTT values, fibrinogen, and D-dimer levels was recorded from all sepsis patients then patients were observed until diagnosed decompensated or non-decompensated DIC, then the value of PT, aPTT, fibrinogen and D-dimer levels in the group of decompensated DIC and non-decompensated DIC were analysed. This study used cohort design. Subjects were 39 sepsis patients (58%) with outcome decompensated DIC and 28 sepsis patients (42%) with outcome non-decompensated DIC. From the hemostasis parameter test out, it was found that PT, aPTT, and fibrinogen were the predictor of decompensated DIC in patients with sepsis with relative risk 240.500, 7.157, and 6.421; respectively...

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Sepsis: a private hospital experience in Nepal

Cited by 8 publications

References 0 publications

Serum Lactate Level as a Predictor of Outcome in Patients with Septic Shock

Serum Lactate Level as a Predictor of Outcome in Patients with Septic Shock

Serum Lactate Albumin Ratio as a Predictor of Mortality in Severe Sepsis and Septic Shock at Tribhuwan University Teaching Hospital, Kathmandu

Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, dan D-dimer Sebagai Prediktor Decompensated Disseminated Intravascular Coagulation Sisseminated pada Sepsis

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