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Abstract

Introduction Consistent data about the incidence and outcome of sepsis in Latin American intensive care units (ICUs), including Brazil, are lacking. This study was designed to verify the actual incidence density and outcome of sepsis in Brazilian ICUs. We also assessed the association between the Consensus Conference criteria and outcome Methods This is a multicenter observational cohort study performed in five private and public, mixed ICUs from two different regions of Brazil. We prospectively followed 1383 adult patients consecutively admitted to those ICUs from May 2001 to January 2002, until their discharge, 28th day of stay, or death. For all patients we collected the following data at ICU admission: age, gender, hospital and ICU admission diagnosis, APACHE II score, and associated underlying diseases. During the following days, we looked for systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock criteria, as well as recording the sequential organ failure assessment score. Infection was diagnosed according to CDC criteria for nosocomial infection, and for community-acquired infection, clinical, radiological and microbiological parameters were used. Results For the whole cohort, median age was 65.2 years (49-76), median length of stay was 2 days (1-6), and the overall 28-day mortality rate was 21.8%. Considering 1383 patients, the incidence density rates for sepsis, severe sepsis and septic shock were 61.4, 35.6 and 30.0 per 1000 patient-days, respectively. The mortality rate of patients with SIRS, sepsis, severe sepsis and septic shock increased progressively from 24.3% to 34.7%, 47.3% and 52.2%, respectively. For patients with SIRS without infection the mortality rate was 11.3%. The main source of infection was lung/respiratory tract. Conclusion Our preliminary data suggest that sepsis is a major public health problem in Brazilian ICUs, with an incidence density about 57 per 1000 patient-days. Moreover, there was a close association between ACCP/SCCM categories and mortality rate.

Assessing available information on the burden of sepsis: global estimates of incidence, prevalence and mortality

“…Table 2 present the characteristics of identified studies of the incidence, prevalence and mortality rate of sepsis at the population level. All the studies reported their own original results based on hospital findings with a clearly defined credible population denominator which in some cases has been used to produce the national estimates that the studies reported [9,10,[13][14][15][16][17][18][19][20][21][22][23][24][25].…”

Polymorphisms IL10-819 and TLR-2 are potentially associated with sepsis in Brazilian patients

“…However, the concept of sepsis is continuously debated in consensus meetings (Bone et al 1992, Levy et al 2003. A multicenter observational cohort study reported that the incidence of sepsis is about 57 per 1,000 patient-days (Silva et al 2004) and another study showed that around 17% of intensive care unit (ICU) beds are occupied by these patients (Sales-Júnior et al 2006). This illness is probably the leading cause of mortality in general and surgical ICU.…”

Challenges in the Management of Sepsis in a Resource-Poor Setting

“…In developed countries, population sepsis incidence ranged from 22 to 240/100,000, of severe sepsis from 13 to 300/100,000 and of septic shock 11/100,000 [14]- [19], with a case fatality rate up to 30% for sepsis, 50% for severe sepsis and 80% for septic shock, depending on the setting and severity of the disease [14]- [19]. In developing countries, national population incidences are unknown, but various hospital based studies among neonates from different countries show a prevalence ranging from 6 -9/1000 live births in Ethiopia to 20.3 -29.3/1000 live births in India [7] [20] [21].…”

Implicações Ósseas na Sepse Sistêmica Aguda: Uma análise química e estrutural

“…Além disso, a morbidade e a presença de alterações funcionais que podem ser desencadeadas pela sepse demonstram a importância da elucidação dos processos patológicos envolvidos nessa síndrome. Um estudo epidemiológico realizado em unidades de terapia intensiva (UTI) do Brasil mostrou que em uma população de 3.128 pacientes, 16,7% foram acometidos pela Sepse e desses 46,6% foram a óbito (Silva et al, 2004). Outro estudo desenvolvido nos estados de São Paulo e Santa Catarina mostrou uma incidência de sepse de 46,9%, com mortalidade de 33,9% desses pacientes.…”

Optimizing beta-lactam antibiotic dosing in critically ill patients: Prolonged infusion versus intermittent bolus administration

“…Based on the Malaysian Registry of Intensive Care report for year 2011, 23.2% of Malaysian ICU patients developed severe sepsis within 24 hours of ICU admission with a mortality rate approaching 60% [36]. Despite an emerging trend for improved survival in ICU patients [32,[37][38][39], the mortality rate in critically ill patients remains unacceptably high worldwide, ranging from 30-50% in severe sepsis and 40-87% in patients with septic shock [37,[40][41][42][43][44][45]. As a consequence, huge hospital resources are spent worldwide on septic patients [46,47].…”