Portuguese network data: epidemiology of community-acquired sepsis

Introduction

A prospective multicentre nationwide study on community-acquired sepsis (CAS) in Portuguese ICUs was created in 2004 with two main objectives: to know the epidemiology and to promote good practice. In this poster we intend to show data collected in the first 10 months.

Methods

Seventeen units came together in this project. It lasted from 1 December 2004 until 30 November 2005. Data collection included epidemiological characteristics and comorbidities, the CAS episode (locale of infection, responsible organism, first intention antibiotherapy and associated organ dysfunction) and the compliance with the SSC recommendations. For statistics, the chi-square and Mann-Whitney tests were used. P < 0.05 was considered significant.

Results

During this period 2643 patients were included in the study and 606 had CAS (23%) – of these, 240 (41%) had severe sepsis and 280 (48%) septic shock. Men had more sepsis (33% of all men) than women (25%, P = 0.004). No significant association was seen between age and sepsis, severity of sepsis or mortality. Twenty-three percent (137 patients) of the septic patients had an infection associated with health care. Forty percent had a microbiologically documented infection, 22% had positive blood cultures. Patients with sepsis had a longer ICU stay (median = 8 days) than those without (median = 5 days). This difference is significant for those who survive (median = 9 vs 5 days, P < 0.01) and for those who died (median = 6 vs 5 days, P = 0.049). Patients with sepsis had higher ICU mortality rate than those without (31% vs 22%, P < 0.01).

Discussion

Comparing with previous similar studies we had: more patients admitted with CAS; more severe sepsis and septic shock; similar distribution by focus of infection; and a low number of microbiological documented infections. New analyses are being done regarding the focus of infection and severity of sepsis, responsible agent, first intention antibiotherapy and mortality.

Figure 1

Focus of infection.