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Epidemiology and outcome of patients with severe sepsis in six Spanish ICUs
Critical Care volume 13, Article number: P344 (2009)
The objective of this study was to describe the epidemiology, consumption of resources and outcome of patients with severe sepsis.
A prospective, observational and multicenter study performed in six Spanish ICUs. Only patients with severe sepsis were included.
A total of 122 patients with severe sepsis were included (female 33.1%; mean age 58.01 ± 15.40 years; mean APACHE II score at admission to the ICU 21.10 ± 8.89). The source of the infection was respiratory in 56.2%, abdominal in 19.2% and other foci in 24.6%. Sepsis-related Organ Failure Assessment (SOFA) scores at the time of diagnosis of severe sepsis were the following: global 10.21 ± 3.75, respiratory 2.66 ± 1.08, haematological 0.75 ± 1.10, hepatic 0.70 ± 1.01, cardiovascular 3.54 ± 1.22, neurological 0.96 ± 1.50, and renal 1.46 ± 1.61. Rates of organ failure were the following: respiratory 93.8%, haematological 38.5%, hepatic 37.7%, cardiovascular 90.8%, neurological 35.4% and renal 55.4%. The rate of use of medical resources was as follows: adrenergic agents 90.8%, mechanical ventilation 86.2%, extrarenal depuration 20% and recombinant activated protein C 15.4%. Mean length of stay in the ICU was 16.88 ± 18.98 days. The mortality rate in the ICU was 43.44%. We found that lactic acid serum levels (OR = 1.26, 95% CI = 1.11 to 1.43, P < 0.001), SOFA score (OR = 1.24, 95% CI = 1.12 to 1.37, P < 0.001) and plasminogen activator inhibitor-1 (PAI-1) plasma levels (OR = 1.02, 95% CI = 1.01 to1.03, P = 0.001) at the time of diagnosis were predictors of mortality.
Severe sepsis is an important cause of mortality and it incurs a considerable use of resources. Lactic acid serum levels, SOFA score and PAI-1 plasma levels at diagnosis were found to be predictors of mortality.
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Lorente, L., Martín, M., Díaz, C. et al. Epidemiology and outcome of patients with severe sepsis in six Spanish ICUs. Crit Care 13, P344 (2009). https://doi.org/10.1186/cc7508
- Plasma Level
- Lactic Acid
- Mechanical Ventilation
- Multicenter Study