The epidemiology of, and risk factors for, mortality from severe sepsis and septic shock in a tertiary-care university hospital setting

Abstract

This study investigated the clinical characteristics of, and outcomes and risk factors for hospital mortality of 390 patients admitted with severe sepsis or septic shock in an intensive care unit (ICU). Prospectively collected data from patients collected between 1 July 2004 and 30 June 2006 were analysed. Overall hospital mortality was 49.7% and comorbidities were found in 40.3% of patients, the most common of which was haematological malignancy. The respiratory tract was the most common site of infection (50%). Hospital-acquired infections accounted for 55.6% of patients with Gram-negative bacteria predominant (68%). Multivariate analysis showed that acute respiratory distress syndrome, pulmonary artery catheter placement, comorbidities, hospital-acquired infection, APACHE II score and maximum LOD score, were independent risk factors for hospital mortality. In conclusion, severe sepsis and septic shock are common causes of ICU admission. Patients with risk factors for increased mortality should be carefully monitored and aggressive treatment administered.

Epidemiology and Outcome Among Severe Sepsis and Septic Shock Patients in a South Indian Tertiary Care Hospital

“…A major proportion of the patients had a positive culture with urinary tract being the predominant site of infection. This is in contrast to other studies [14,15] which have reported lung as the major source of infection. Since ours is a tertiary care hospital, the majority of the patients have a history of prior hospitalization and urinary catheterization, which may be the reason for the present observation.…”

“…Gram-negative organisms remained the major pathogens in our study which is in accordance with earlier studies [14,15]. Antibiotic resistance is emerging as a serious problem due to inappropriate antibiotic use in both grams negative and gram positive organisms.…”

Community- and healthcare-associated infections in critically ill patients: a multicenter cohort study

“…The nosocomial group had a statistically higher incidence of fungal infection (29% vs. 14%) probably due to a higher use of invasive interventions or procedures, total parenteral nutrition or other known risk factors for candida infection [24]. Microbiological distribution is however different from other studies where gram-positive cocci predominated overall [16] and fungi were similar in both categories [6][7][8][9][10][11][12][13][14][15][16][17][18]. This difference is likely due to country variability affecting patients' microbial profile on inclusion.…”

Pre-B-Cell Colony-Enhancing Factor and Its Clinical Correlates With Acute Lung Injury and Sepsis

“…31 In addition, our fi ndings that older age, failure to achieve resuscitation goals within 6 h of sepsis, lung injury, and APACHE III score were signifi cantly associated with mortality in sepsis is also consistent with prior reports. [32][33][34][35][36] PBEF is believed to play an important role in the development of ALI. Li et al 24 suggested PBEF as a facilitator of pulmonary infl ammation and alveolar epithelial barrier dysfunction via its regulation of other infl ammatory cytokines (eg, IL-8).…”