The spectrum and outcome of surgical sepsis in Pietermaritzburg, South Africa

Green, S; Kong, Victor; Clarke, Damian; Sartorius, Benn; Odendaal, Jocinta; Bruce, John; Laing, G L; Brysiewicz, Petra; Bekker, W; Harknett, E

doi:10.7196/samj.2017.v107i2.11339

Cited by 10 publications

(15 citation statements)

References 19 publications

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“…Most of the patients presenting with sepsis syndrome were <60 years old. This was similar to a recent local study profiling surgical sepsis, which reported a mean age of 46 years [5]. This is in contrast to first world countries where sepsis syndrome is prevalent in the elderly [6].…”

Section: Discussionsupporting

confidence: 89%

“…A study in an Emergency Centre (EC) in a developing country reported a hospital mortality rate of 43% in patients presenting with severe sepsis [4]. A recent study describing the spectrum and outcomes of patients with surgical sepsis reported an overall mortality rate of 12.7% [5]. With the high prevalence of Human Immunodeficiency Virus (HIV) and other infections in Africa, it is likely that the burden of sepsis syndrome is equal or even higher than that estimated from developed countries.…”

Section: Introductionmentioning

confidence: 99%

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The epidemiology of sepsis in a district hospital emergency centre in Durban, KwaZulu natal

Ndadane

Maharaj

2019

African Journal of Emergency Medicine

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IntroductionSepsis is one of the leading causes of death worldwide. There is a paucity of data describing the epidemiology of sepsis in emergency centres in developing countries. This study aims to describe the clinical profile and management of patients presenting with sepsis in this setting.MethodsA retrospective chart review was conducted in an Emergency Centre (EC) of a district hospital in Durban from December 2015 to February 2016. All patients with a diagnosis of an infection that met the Surviving Sepsis Campaign criteria for sepsis syndrome were included in the study.ResultsA total of 1195 patients who were diagnosed with an infection were screened. Of these, 52 of them met the inclusion criteria for the study. The criteria for severe sepsis was met in 40.3% (n 23) and 1.9% (n 1) met the criteria for septic shock. More than half of the patients were HIV positive and 30.7% did not know their HIV status. The most common sites of infection were respiratory tract, gastrointestinal and central nervous system respectively. Most patients were admitted to the general medical ward. The inpatient mortality rate was 15% for general medical ward admissions.ConclusionA better understanding of the demographic and clinical profile of sepsis syndrome in South African ECs is required to guide clinical and operational policy development.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

The epidemiology of sepsis in a district hospital emergency centre in Durban, KwaZulu natal

Ndadane

Maharaj

2019

African Journal of Emergency Medicine

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“…[11] While there was a preponderance of surgical patients and patients with intra-abdominal sepsis in the study, the cohort comprised a spectrum of patients, a significant number of whom had pneumonia and skin and soft-tissue infections. [12] As expected of a cohort of patients in septic shock, mortality was relatively high at 49.4%. This figure is in keeping with the median admission SOFA score of 10.…”

Section: Discussionmentioning

confidence: 54%

“…The critical care data from the South African Surgical Outcomes Study indicated that significant differences exist between South African (SA) critical care patients and those in HICs: they were significantly younger, had a significantly RESEARCH lower rate of ICU admission and underwent more urgent surgery than the European Surgical Outcomes Study patients. [11] A recent local publication [12] showed that the spectrum of surgical sepsis presenting to SA hospitals is different from that seen in HICs. Their patient cohort was much younger and generally presented with more advanced disease.…”

Section: Researchmentioning

confidence: 99%

The utility of hyperlactataemia in the definition of septic shock: Evaluating the Sepsis-3 definitions in a sub-Saharan African intensive care unit

Elhouni

Vasconcellos

2019

S Afr Med J

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“…2). (14). The ratio of male to female from the WISS study was 1.3:1, mean age 51.2 years (range 18-99 years) (8).…”

Section: Resultsmentioning

confidence: 96%

Utility of World Society of Emergency Surgery Sepsis Severity Score in Predicting Outcomes of Intra-abdominal Infections

Mwenda¹,

Ojuka²,

Awori³

2020

Ann Afr Surg.

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Background: Intra-abdominal infections are classified as simple or complicated. Many tools have been studied to predict risk factors and outcomes of patients with intra-abdominal infections. None of these tools has been adopted for patient care at the Kenyatta National Hospital (KNH), Kenya. Objective: To determine the utility of the World Society of Emergency Surgery (WSES) Sepsis Severity Score in predicting short-term outcomes of patients managed for complicated intra-abdominal infections. Methods: We conducted a hospital-based prospective cohort study. Patients aged 18 years and above with complicated intra-abdominal infections were recruited. Data were obtained on demographics, condition at admission, time to source control, origin of infection, immune suppressants and complications. IBM SPSS version 21.0 was used to obtain means and standard deviations while logistic regression was used for associations. Results: A sepsis severity score of 6.5, best predicted mortality having a sensitivity of 80% and a specificity of 20.9% were obtained. For each unit increase in the WSES scores, the odds of mortality were 2.1, organ dysfunction 2.2, CCU admission 2.1. Conclusion: Our sepsis severity score has demonstrated good performance in our adult population, and also ability to predict adverse outcomes other than mortality in patients managed for intra-abdominal sepsis. Keywords: WSES, Sepsis, Sepsis severity score, Intra-abdominal infections

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The spectrum and outcome of surgical sepsis in Pietermaritzburg, South Africa

Cited by 10 publications

References 19 publications

The epidemiology of sepsis in a district hospital emergency centre in Durban, KwaZulu natal

The epidemiology of sepsis in a district hospital emergency centre in Durban, KwaZulu natal

The utility of hyperlactataemia in the definition of septic shock: Evaluating the Sepsis-3 definitions in a sub-Saharan African intensive care unit

Utility of World Society of Emergency Surgery Sepsis Severity Score in Predicting Outcomes of Intra-abdominal Infections

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