Article information
Abstract
Objectives
The objective of this study was to estimate disease incidence and mortality rate of sepsis in a tertiary public hospital.
MethodsPatients admitted to the Intensive Care Unit (ICU) in 2004 and 2005 were monitored for sepsis using an observational longitudinal study design. Patients were monitored daily for diagnostic criteria of sepsis, according to ACCP/SCCM Consensus Conference criteria, until either death or hospital discharge.
ResultsDuring the study, we analyzed 1,179 patients. Systemic Inflammatory Response Syndrome (SIRS) was present in 1,048 (88.9%) patients on admission, and was associated with infection in 554 (47.0%) patients. Of these, sepsis was diagnosed in 30 (2.5%) patients, while severe sepsis was diagnosed in 269 (22.8%) patients, and septic shock was diagnosed in 255 (21.6%) patients. APACHE II and SOFA scores were higher in septic patients (p < 0.001), and the ensuing mortality rates were 32.8% (IC 95%: 21.6-45.7%) for patients with sepsis, 49.9% (IC 95%: 44.5-55.2%) for severe sepsis, and 72.7% (IC 95%: 68.1-76.9%) for septic shock.
ConclusionsThe data from our study revealed a high incidence of sepsis among hospitalized patients. Moreover, sepsis patients had a high rate of mortality.
Keywords:
sepsis
incidence
mortality
epidemiology
Full text is only aviable in PDF
References
[1.]
W.T. Linde-Zwirble, D.C. Angus.
Severe sepsis epidemiology: sampling, selection, and society [commentary].
Crit Care, 8 (2004), pp. 222-226
[2.]
D.C. Angus, W.T. Linde-Zwirble, J. Lidicker, et al.
Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care.
Crit Care Med, 29 (2001), pp. 1303-1310
[3.]
G.S. Martin, D.M. Mannino, S. Eaton, et al.
The Epidemiology of Sepsis in the United States from 1979 through 2000.
N Engl J Med, 348 (2003), pp. 1546-1554
[4.]
V.Y. Dombrovskiy, A.A. Martin, J. Sunderram, H.L. Paz.
Rapid increase in hospitalization and mortality rates for severe sepsis in the United States: A trend analysis from 1993 to 2003.
Crit Care Med, 35 (2007), pp. 1244-1250
[5.]
American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference.
Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.
Crit Care Med, 20 (1992), pp. 864-874
[6.]
D.C. Angus, C.A.P. Pereira, E. Silva.
Epidemiology of severe sepsis around the world.
Endocr Metab Immune Disord Drug Targets, 6 (2006), pp. 7-16
[7.]
J.L. Vincent, Y. Sakr, C.L. Sprung, et al.
Sepsis in European intensive care units: Results of the SOAP study.
Crit Care Med, 34 (2006), pp. 344-353
[8.]
S.P. León-Rosales, F. Molinar-Ramos, G. Domínguez-Cherit, M.S. Rangel-Frausto, V.G. Vázquez-Ramos.
Prevalence of infections in intensive care units in Mexico: A multicenter study.
Crit Care Med, 28 (2000), pp. 1316-1321
[9.]
L.A. Dougnac, F.M. Mercado, R.R. Cornejo, et al.
Prevalencia de sepsis grave en las unidades de cuidado intensivo. Primer estúdio nacional multicéntrico.
Rev Med Chil, 135 (2007), pp. 620-630
[10.]
E. Silva, M. Pedro, A. de, A.C. Sogayar, et al.
Brazilian Sepsis Epidemiological Study (BASES study).
Crit Care, 8 (2004), pp. R251-R260
[11.]
R. Moreno, S. Afonso, T. Fevereiro.
Incidence of sepsis in hospitalized patients.
Current Infectious Disease Reports, 8 (2006), pp. 346-350
[12.]
W.A. Knaus, E.A. Draper, D.P. Wagner, J.E. Zimmerman.
APACHE II: A severity of disease classification system.
Crit Care Med, 13 (1985), pp. 818-828
[13.]
J.L. Vincent, A. de Mendonça, F. Cantraine, et al.
Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: Results of a multicenter, prospective study.
Crit Care Med, 26 (1998), pp. 1793-1800
[14.]
J.S. Garner, W.R. Jarvis, T.G. Emori, T.C. Horan, J.M. Hughes.
CDC definitions for nosocomial infections, 1988.
Am J Infect Control, 16 (1988), pp. 128-140
[15.]
J.L. Fleiss.
Statistical methods for rates and proportions.
2th edn., John Wiley & Sons, (1981),
[16.]
R. Záhorec, J. Firment, J. Straková, et al.
Epidemiology of severe sepsis in intensive care units in the Slovak Republic.
Infection, 33 (2005), pp. 122-128
[17.]
I. Salvo, W. de Cian, M. Musicco, et al.
The Italian SEPSIS study: preliminary results on the incidence and evolution of SIRS, sepsis, severe sepsis and septic shock.
Intensive Care Med, 21 (1995), pp. S244-S249
[18.]
C. Brun-Buisson, P. Meshaka, P. Pinton, B. Vallet, EPISEPSIS Study Group.
EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive care units.
Intensive Care Med, 30 (2004), pp. 580-588
[19.]
C. Engel, F.M. Brunkhorst, H.G. Bone, et al.
Epidemiology of sepsis in Germany: results from a national prospective multicenter study.
Intensive Care Med, 33 (2007), pp. 606-618
[20.]
C. Albert, C. Brun-Buisson, H. Burchardi, et al.
Epidemiology of sepsis and infection in ICU patients from an international multicentre cohort study.
Intensive Care Med, 28 (2002), pp. 108-121
[21.]
A. Padkin, C. Goldfrad, A.R. Brady, et al.
Epidemiology of severe sepsis occurring in the first 24 hrs in intensive care units in England. Wales, and Northern Ireland.
Crit Care Med, 31 (2003), pp. 2332-2338
[22.]
D.A. Harrison, A.W. Catherine, J.M. Eddleston.
The epidemiology of severe sepsis in England. Wales and Northern Ireland, 1996 to 2004: secondary analysis of a high quality clinical database, the ICNARC case mix programme database.
Crit Care, 10 (2006), pp. R42
[23.]
C. Adrie, C. Alberti, C. Chaix-Couturier, et al.
Epidemiology and economic evaluation of severe sepsis in France: age, severity, infection site, and place of acquisition (community, hospital, or intensive care unit) as determinants of workload and cost.
J Crit Care, 20 (2005), pp. 46-58
[24.]
Cardoso LTQ. Admissão tardia em unidade de terapia intensiva como fator de risco para mortalidade: um estudo de coorte prospectivo [thesis]. Londrina, PR, Brazil: Universidade Estadual de Londrina; 2008, 82 pp.
[25.]
J.L. Vincent, D.J. Bihari, P.M. Suter, et al.
The prevalence of nosocomial infection in intensive care units in Europe. Results of the European Prevalence of Infection in Intensive Care (EPIC) Study.
JAMA, 274 (1995), pp. 639-644
[26.]
S. Karlsson, M. Varpula, E. Ruokonen, et al.
Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study.
Intensive Care Med, 33 (2007), pp. 435-443
[27.]
F. Zanon, J.J. Caovilla, R.S. Michel, et al.
Sepse na unidade de terapia intensiva: etiologias, fatores prognósticos e mortalidade.
Revista Brasileira de Terapia Intensiva, 20 (2008), pp. 128-134
[28.]
C. Albert, C. Brun-Buisson, S.V. Goodman, et al.
Influence of systemic inflammatory response syndrome and sepsis on outcome of critically Ill infected patients.
Am J Respir Crit Care Med, 168 (2003), pp. 77-84
[29.]
J.M. O Brien Jr., B. Lu, N.A. Ali, et al.
Alcohol dependence is independently associated with sepsis, septic shock, and hospital mortality among adult intensive care unit patients.
Crit Care Med, 35 (2007), pp. 345-350
[30.]
G.S. Martin, D.M. Mannino, M. Moss.
The effect of age on the development and outcome of adult sepsis.
Crit Care Med, 34 (2006), pp. 15-21
[31.]
P. Damas, D. Ledoux, M. Nys, et al.
Intensive care unit acquired infection and organ failure.
Intensive Care Med, 34 (2008), pp. 856-864
[32.]
R.P. Dellinger, M.M. Levy, J.M. Carlet, et al.
International guidelines for management of severe sepsis and septic shock: 2008.
Crit Care Med, 36 (2008), pp. 296-327
[33.]
D. Annane, P. Aegerter, M.C. Jars-Guincestre, et al.
Current epidemiology of septic shock. The CUB-RÉA Network.
Am J Respir Crit Care Med, 168 (2003), pp. 165-172
Copyright © 2010. Elsevier Editora Ltda.. All rights reserved
