Izvorni znanstveni članak
https://doi.org/10.3325/cmj.2020.61.42 9
Sepsis and septic shock – an observational study of the incidence, management, and mortality predictors in a medical intensive care unit
Vesna Vucelić
; Department of Medicine, Intensive Care Unit, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Iva Klobučar
; Department of Cardiology, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Branka Đuras Cuculić
; Department of Medicine, Intensive Care Unit, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Ana Gverić Grginić
; Department of Microbiology, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Carmen Prohaska Potočnik
; Department of Microbiology, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Ines Jajić
; Department of Microbiology, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Željko Vučičević
; Department of Medicine, Intensive Care Unit, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Vesna Degoricija
; Department of Medicine, Intensive Care Unit, “Sestre Milosrdnice” University Hospital Center, Zagreb, Croatia
Sažetak
Aim To prospectively determine the number of patients
with sepsis and septic shock in a medical intensive care
unit (ICU) using the Sepsis-3 definition; to analyze patients’
characteristics, clinical signs, diagnostic test results, treat
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ment and outcomes; and to define independent risk fac
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tors for ICU mortality.
Methods This prospective observational study enrolled all
patients with the diagnosis of sepsis treated in the medical
ICU of “Sestre Milosrdnice” University Hospital Center, Za
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greb, between April 2017 and May 2018.
Results Out of 116 patients with sepsis, 54.3% were fe
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male. The median age was 73.5 years (IQR 63-82). The lead
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ing source of infection was the genitourinary tract (56.9%),
followed by the lower respiratory tract (22.4%). A total of
35.3% of the patients experienced septic shock. Total ICU
mortality for sepsis was 37.9%: 63.4% in patients with sep
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tic shock and 24.0% in patients without shock. Indepen
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dent risk factors for ICU mortality were reduced mobility
level (odds ratio [OR] 11.16, 95% confidence interval [CI]
2.45-50.91), failure to early recognize sepsis in the emer
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gency department (OR 6.59, 95% CI 1.09-39.75), higher Se
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quential Organ Failure Assessment score at admission (OR
2.37, 95% CI 1.59-3.52), and inappropriate antimicrobial
treatment (OR 9.99, 95% CI 2.57-38.87).
Conclusion While reduced mobility level and SOFA score
are predetermined characteristics, early recognition of sep
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sis and the choice of appropriate antimicrobial treatment
could be subject to change. Raising awareness of sepsis
among emergency department physicians could improve
its early recognition and increase the number of timely ob
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tained specimens for microbial cultures.
Ključne riječi
Hrčak ID:
277991
URI
Datum izdavanja:
23.10.2020.
Posjeta: 406 *