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Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean.
Singh, Keevan; Hariharan, Seetharaman; Ventour, Dale; Chen, Deryk R; Merritt-Charles, Lorna G; Sookwah, Mark; Maharaj, Daynish; Sankar-Maharaj, Sasha.
Afiliación
  • Singh K; Anaesthesia and Intensive Care, University of the West Indies, St Augustine, TTO.
  • Hariharan S; Anaesthesia and Intensive Care, San Fernando General Hospital, San Fernando, TTO.
  • Ventour D; Anaesthesia and Intensive Care, University of the West Indies, St Augustine, TTO.
  • Chen DR; Anaesthesia and Intensive Care, Eric Williams Medical Sciences Complex, Mt. Hope, TTO.
  • Merritt-Charles LG; Anaesthesia and Intensive Care, University of the West Indies, St Augustine, TTO.
  • Sookwah M; Anaesthesia and Intensive Care, Eric Williams Medical Sciences Complex, Mt. Hope, TTO.
  • Maharaj D; Anaesthesia and Intensive Care, Eric Williams Medical Sciences Complex, Mt. Hope, TTO.
  • Sankar-Maharaj S; Anaesthesia and Intensive Care, University of the West Indies, St Augustine, TTO.
Cureus ; 12(10): e10980, 2020 Oct 16.
Article en En | MEDLINE | ID: mdl-33209536
Objectives To investigate the epidemiology, management, and predictors of mortality in severe sepsis and septic shock in the intensive care units (ICUs) of Trinidad, Trinidad & Tobago. Methods A prospective observational study in four ICUs over a one-year period (August 2017-August 2018) was conducted. Physiologic variables, treatment data, and outcomes were collected on admission to ICU and daily until 28 days. The 28-day mortality and ICU mortality were recorded. Subgroup analysis was performed based on survival, and predictors of mortality were determined through logistic regression. Results Outcome data were available for 163 patients. The 28-day mortality rates for sepsis and septic shock were 42% and 47%, respectively. ICU mortality rate for sepsis was 34%. The most common suspected source of infection was pneumonia (33%). Acute kidney injury (AKI) was common and present in 71% of patients, with renal replacement therapy only being used in 30% of cases. Mechanical ventilation was required in 84% of cases. Moderate-to-severe acute respiratory distress syndrome (ARDS) (OR: 4; 95% CI: 1.9-8.8; p < 0.001) and the development of AKI (all stages) (OR: 10; 95% CI: 3.9-30.2; p < 0.001) were found to be predictive of mortality. Incidence of mechanical ventilation, moderate-to-severe ARDS, stage 3 AKI, septic shock, and failure to achieve a mean arterial pressure of > 60 mmHg within the first 24 hours of admission were higher in patients who did not survive (p < 0.05). Conclusions Sepsis and septic shock are associated with a high 28-day mortality. Organ dysfunction with renal and pulmonary involvement was an important factor in predicting a higher mortality.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: Cureus Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies / Screening_studies Idioma: En Revista: Cureus Año: 2020 Tipo del documento: Article Pais de publicación: Estados Unidos