Brazilian Sepsis Epidemiological Study (BASES): preliminary results from first 439 patients

Introduction

Severe sepsis is one of the major causes of mortality in intensive care units (ICUs) around the world. There are few epidemiological studies based on ACCP/SCCM consensus conference criteria. The incidence of severe sepsis is largely unknown in countries like Brazil.

Objective

To determine the incidence and outcome of sepsis in Brazilian ICUs.

Methods

This is an observational, prospective, multicenter cohort study from four adult, general ICUs from two Brazilian regions. From May to October 2001, all patients admitted to those ICUs were prospectively followed for 28 days or until discharge. Demographic data, admission diagnosis, associated chronic diseases, APACHE II score, daily SOFA score, clinical and laboratory SIRS, sepsis, and septic shock criteria, as well as early and late outcome were collected. Data management was performed by a TELEform Elite V6 – Cardiff Software. Data were expressed as mean ± standard error. The t-test was used to compare mortality rates in different diagnostic categories.

Results

Mean age was 63 ± 1 years and overall mortality rate was 20%. Mean ICU length of stay was 4.5 ± 1.7 days. The main admission diagnoses (by APACHE II diagnosis categories) were sepsis, cancer, neurologic disturbances, cardiovascular surgery and metabolic disorders.

Conclusion

In those patients with more than 24 hours of ICU length of stay, the incidence of sepsis was of 34.7%. ACCP/ SCCM definitions were feasible and were associated with mortality rates. Expansion of these data to other Brazilian regions is crucial to estimate the actual incidence of sepsis in our ICUs.

Supported by a grant from Eli Lilly of Brazil.

Table 1 Incidence and outcome in 354 patients with more than 24 hours of ICU length of stay, based on ACCP/SCCM conference definitions