Epidemiology and Management Trends of Patients With Sepsis and Septic Shock in the Intensive Care Unit: A Prospective Trial in the Caribbean

Curēus
Keevan SinghSasha Sankar-Maharaj

Abstract

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. In...Continue Reading

References

Aug 18, 2004·Critical Care : the Official Journal of the Critical Care Forum·Eliézer SilvaUNKNOWN Brazilian Sepsis Epidemiological Study
Dec 17, 2010·The American Journal of Emergency Medicine·Emmanuel MontassierGille Potel
Jul 17, 2012·JAMA : the Journal of the American Medical Association·V Marco RanieriArthur S Slutsky
Nov 10, 2013·Critical Care Medicine·Elizabeth K StevensonAllan J Walkey
Feb 18, 2014·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Hiroshi OguraUNKNOWN Japanese Association for Acute Medicine Sepsis Registry (JAAMSR) Study Group
Mar 19, 2014·The New England Journal of Medicine·Donald M YealyDerek C Angus
Oct 2, 2014·The New England Journal of Medicine·Sandra L PeakePatricia Williams
Oct 3, 2014·Critical Care Medicine·Mitchell M LevyR Phillip Dellinger
Mar 18, 2015·The New England Journal of Medicine·Paul R MounceyUNKNOWN ProMISe Trial Investigators
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Manu Shankar-HariUNKNOWN Sepsis Definitions Task Force
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Giacomo BellaniUNKNOWN ESICM Trials Group
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
Mar 26, 2016·The Lancet Global Health·Wasiu A OlowuValerie A Luyckx
Jan 20, 2017·Intensive Care Medicine·Andrew RhodesR Phillip Dellinger
Mar 30, 2017·Intensive Care Medicine·Marcus J SchultzUNKNOWN Global Intensive Care Working Group of the European Society of Intensive Care Medicine
Jun 26, 2018·Lancet·Maurizio CecconiAndrew Rhodes

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Statistical Package for Social Sciences ( SPSS )

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