Epidemiology of sepsis in a Brazilian teaching hospital

Introduction

Sepsis is a great concern in public health due to high incidence and mortality. The objective of the present study is to estimate the incidence and mortality rate of sepsis in a tertiary public hospital, in Londrina, Paraná, Brazil.

Methods

An observational longitudinal study of patients admitted to the ICU in a 2-year period. Demographic and diagnostic data were collected on admission. APACHE II and SOFA scores were obtained as originally described. Patients were monitored daily for diagnostic criteria of sepsis according to ACCP/SCCM Consensus Meeting Definitions, until death or hospital discharge.

Results

We analyzed 1,179 patients during the study period. SIRS was present in 1,048 (88.9%) patients on admission, and was associated with infection in 554 (46.9%) patients. Sepsis was diagnosed in 30 (2.5%) patients, severe sepsis in 269 (22.8%) patients and septic shock in 255 (21.6%) patients on admission. Observing the total ICU length of stay, there were 64 (5.4%) cases of sepsis, 353 (29.9%) cases of severe sepsis and 412 (34.9%) cases of septic shock. Pneumonia was the most frequent infection site (66.5%). Comparing patients according to the presence of sepsis, male sex was more frequent among septic patients (60.0%) compared with nonseptic patients (52.9%) (P = 0.015). Septic patients were older (P < 0.001) and presented a longer ICU and hospital length of stay (P < 0.001). Chronic diseases were more frequent among septic patients (16.6%) than nonseptic patients (8.9%) (P < 0.001). APACHE II and SOFA scores were higher in septic patients (P < 0.001). The mortality rate was 32.8% (95% CI = 21.6 to 45.7%) for patients with sepsis, 499% (95% CI = 44.5 to 55.2%) for severe sepsis and 72.7% (95% CI = 68.1 to 76.9%) for septic shock.

Conclusion

We detected high incidence and mortality rate of sepsis in our sample of patients.