ASSESSMENT OF THE OUTCOME OF SEPSIS PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT

Authors

  • R PERVAIZ Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • B ARIF Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • MS HASHMI Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • H AHMED Department of Critical Care Medicine, Bahria International Hospital, Lahore, Pakistan
  • . ADEEL Department of Critical Care Nursing, Bahria International Hospital, Lahore, Pakistan
  • A ASGHAR Department of Critical Care Nursing, Bahria International Hospital, Lahore, Pakistan
  • S ZARTASH Department of Critical Care Medicine, Services Institute of Medical Sciences, Lahore, Pakistan

DOI:

https://doi.org/10.54112/pjicm.v3i01.21

Keywords:

Sepsis, Septic Shock, Intensive Care Unit, Mortality, Risk Factors, Blood Culture, Outcome Assessment, Respiratory Complications, Renal Complications, Neurological Complications

Abstract

Background: Sepsis remains a significant challenge in critical care medicine, with high morbidity and mortality rates, particularly among patients admitted to the intensive care unit (ICU). Understanding sepsis outcomes in the ICU is crucial for guiding clinical management decisions and improving patient care practices. Objective: This study aimed to assess the consequences of severe sepsis and septic shock in patients admitted to the ICU at Bahria Town International Hospital Lahore, focusing on mortality rates, risk factors for death, and site of infection. Study Design: A prospective clinical study adhering to STROBE guidelines was conducted at the ICU of Bahria Town International Hospital Lahore from March 2023 to December 2023. Setting: The study was conducted at the Intensive Care Unit (ICU) of Bahria Town International Hospital Lahore. Duration of Study: The study was conducted from March 2023 to December 2023. Material and Methods: Patients aged 18 years and older admitted to the ICU with severe sepsis or septic shock were included. Exclusion criteria included ICU length of stay shorter than 24 hours and patients under 18 years old. Data on demographics, infection source, comorbidities, laboratory results, hospital stay, and outcomes were prospectively collected using a predefined form. Data analysis was performed using SPSS 21 software, including descriptive statistics and binary logistic regression, to identify variables affecting patient survival. Results: Sixty individuals were enrolled, with a mean age of 55.55 ± 20.32 years. The majority were male (58.3%). The mean length of hospital stay was 6.43 ± 3.54 days. Among the study population, 43.3% had severe sepsis, and 56.6% had septic shock. The mortality rate was 41.6%. Positive blood culture was associated with a higher mortality rate, and patients with septic shock had a significantly increased risk of death. Complications with the respiratory, renal, and central neurological systems also increased the likelihood of death. Conclusion: This study highlights the significant mortality associated with severe sepsis and septic shock in ICU patients. Positive blood culture and septic shock were identified as important predictors of mortality. Early recognition and management of these factors are essential for improving patient outcomes in sepsis.

References

Ranjit S, Kissoon N. Challenges and solutions in translating sepsis guidelines into practice in resource-limited settings. Translational Pediatrics. 2021;10(10):2646.

Izquierdo-Condoy JS, Vasconez-Gonzales J, Morales-Lapo E, Tello-De-la-Torre A, Naranjo-Lara P, Fernandez R, et al. Beyond the acute phase: a comprehensive literature review of long-term sequelae from infectious diseases. Frontiers in Cellular and Infection Microbiology. 2024;14:1293782.

Elhadi M, Khaled A, Msherghi A. Infectious diseases as a cause of death among cancer patients: trend analysis and population-based study of outcome in the United States based on the Surveillance, Epidemiology, and End Results database. Infectious agents and cancer. 2021;16:1-11.

Markwart R, Saito H, Harder T, Tomczyk S, Cassini A, Fleischmann-Struzek C, et al. Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis. Intensive care medicine. 2020;46:1536-51.

Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990–2017: analysis for the Global Burden of Disease Study. The Lancet. 2020;395(10219):200-11.

Torres LK, Pickkers P, van der Poll T. Sepsis-induced immunosuppression. Annual review of physiology. 2022;84:157-81.

Fleischmann-Struzek C, Mellhammar L, Rose N, Cassini A, Rudd K, Schlattmann P, et al. Incidence and mortality of hospital-and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis. Intensive care medicine. 2020;46:1552-62.

Prest J, Sathananthan M, Jeganathan N. Current trends in sepsis-related mortality in the United States. Critical care medicine. 2021;49(8):1276-84.

Schmidt K, Gensichen J, Fleischmann-Struzek C, Bahr V, Pausch C, Sakr Y, et al. Long-Term Survival Following Sepsis: Results of a Single-Center Registry Study with 4-Year Follow-Up. Deutsches Ärzteblatt International. 2020;117(46):775.

Stephen Varghese S. Outcomes in elderly patients admitted with sepsis in a tertiary care hospital: A Follow-up Observational study: Christian Medical College, Vellore; 2020.

Ahmed AS, Hussain E, Haleem S, Ahmed N, Latif A. Epidemiology of sepsis, based on ICD-9 coding, a tertiary care experience from Pakistan. Trends in Anaesthesia and Critical Care. 2021;41:37-46.

Odeh H. THE PREVALENCE OF SEPSIS AND SEPTIC SHOCK: TREATMENT OUTCOMES AMONG ICU PATIENTS AT A TERTIARY HOSPITAL IN PALESTINE: جامعة النجاح الوطنية; 2022.

Bonten M, Johnson JR, van den Biggelaar AH, Georgalis L, Geurtsen J, de Palacios PI, et al. Epidemiology of Escherichia coli bacteremia: a systematic literature review. Clinical Infectious Diseases. 2021;72(7):1211-9.

Auriemma CL, Zhuo H, Delucchi K, Deiss T, Liu T, Jauregui A, et al. Acute respiratory distress syndrome-attributable mortality in critically ill patients with sepsis. Intensive care medicine. 2020;46:1222-31.

Fay K, Sapiano MR, Gokhale R, Dantes R, Thompson N, Katz DE, et al. Assessment of health care exposures and outcomes in adult patients with sepsis and septic shock. JAMA network open. 2020;3(7):e206004-e.

Gad MH, AbdelAziz HH. Catheter-associated urinary tract infections in the adult patient group: a qualitative systematic review on the adopted preventative and interventional protocols from the literature. Cureus. 2021;13(7).

Gauer R, Forbes D, Boyer N. Sepsis: diagnosis and management. American family physician. 2020;101(7):409-18.

Downloads

Published

2023-06-21

How to Cite

PERVAIZ , R., ARIF, . B., HASHMI, . M., AHMED, H., ADEEL, ., ASGHAR, A., & ZARTASH, S. (2023). ASSESSMENT OF THE OUTCOME OF SEPSIS PATIENTS ADMITTED TO THE INTENSIVE CARE UNIT. Pakistan Journal of Intensive Care Medicine, 3(01), 21. https://doi.org/10.54112/pjicm.v3i01.21

Issue

Section

Original Research Articles

Most read articles by the same author(s)

<< < 1 2 3 > >>