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Sepsis Brazil: an epidemiological study in intensive care units

Introduction

Sepsis represents the major cause of death in the ICUs all over the world. Many studies have shown an increasing incidence over time and only a slight reduce in mortality. Many new treatment strategies are arising and we should know our incidence of sepsis and features.

Methods

A prospective cohort study in 50 hospitals of all regions of Brazil. The patients who were admitted or who developed sepsis during the month of September 2003 were enrolled. They were followed until the 28th day. The diagnoses were made in accordance with the criteria proposed by ACCP/SCCM. Demographic features, APACHE II score, Sepsis-related Organ Failure Assessment (SOFA) score, mortality, sources of infections and lengh of stay (LOS) were evaluated.

Results

A total of 2419 patients were identified and 409 (16.9%) filled the criteria of sepsis, severe sepsis or septic shock. The average age was 61.9 years, 225 (55%) were male, and the overall 28-day mortality rate was 46.2%. The average APACHE II score was 21 and the SOFA score on the first day was 7. The SOFA score in the mortality group was higher on day 1 (8), and had increased on day 3. We observed 326 episodes of sepsis, 118 (28.9%) patients with severe sepsis, and 210 (51.4%) patients with septic shock. The mortality rate for sepsis, severe sepsis and septic shock was 15%, 35.6% and 63.8%, respectively. The average LOS was 16 days. The main source of infection was the respiratory tract (71.6%). Gram-negative bacilli were more prevalent (55.6%). Gram-positive cocci accounted for 32% and fungi infections for 10.6%.

Conclusion

A high incidence and mortality of sepsis in ICUs in our country was observed. The high frequency of severe sepsis and septic shock demonstrated a group at high risk of death. In order to have a better use of the resources and to promote a reduction in mortality in the next 5 years it is very important to identify our specific features. After the final analysis of the database we intend to give our contribution to a better understanding of sepsis in Brazil.

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Sales, J., David, C., Souza, P. et al. Sepsis Brazil: an epidemiological study in intensive care units. Crit Care 9, P197 (2005). https://doi.org/10.1186/cc3260

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Keywords

  • Mortality Rate
  • Intensive Care Unit
  • Demographic Feature
  • Respiratory Tract
  • Septic Shock