EPIDEMIOLOGY AND OUTCOME AMONG SEVERE SEPSIS AND SEPTIC SHOCK PATIENTS IN A SOUTH INDIAN TERTIARY CARE HOSPITAL

Merin Babu; Vidya P Menon; Uma Devi P.

doi:10.22159/ijpps.2017v9i5.17102

Authors

Merin Babu Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Amrita University, Kochi, India
Vidya P Menon Department of Internal Medicine, Amrita Institute of Medical Sciences, Amrita University, Kochi, India
Uma Devi P. Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Amrita University, Kochi, India

DOI:

https://doi.org/10.22159/ijpps.2017v9i5.17102

Keywords:

Severe sepsis, Septic shock, Mortality

Abstract

Objective: The objective of this research was to determine the prevalence of severe sepsis and septic shock and evaluate its outcome.

Methods: This was a prospective, observational study, in which adult patients with severe sepsis or septic shock were included. Relevant information was collected from medical records and the hospital information system.

Results: A total of 250 patients [mean age 57.2 y (range: 18 to 98 y)] was studied. The majority of the patients suffered from severe sepsis (81.2%). Most of the episodes occurred in males (75.2%). Major comorbidities included diabetes mellitus (51.2%), hypertension (44.8%) and chronic liver disease (30.4%). One hundred and seventy-eight patients (147 patients with severe sepsis and 31 patients with septic shock) had a positive culture with urine being the main site of infection. One hundred and two patients (40.8%) had a monomicrobial infection while seventy-six (30.4%) patients had a polymicrobial infection. Within the monomicrobial infections, the gram negative organisms predominated (54%). The mean hospital stay for patients with severe sepsis was 11.5 d. Mortality was noted in 79 patients (40 patients with septic shock and 39 patients with severe sepsis).

Conclusion: The main causative pathogens were gram negative bacteria. Admissions meeting septic shock criteria have a high mortality rate. Hence, it is imperative to identify patients who are at high risk and treat them promptly to reduce serious consequences.

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References

Stehr SN, Reinhart K. Sepsis as a global health problemâ€“why we need a global sepsis alliance. Shock 2013;39 Suppl 1:3-4.

Harikesh Maurya, Susheel Kumar Dubey, Poonam Bisht, Monika Semwal, Sanjay Gandhi. An updates on the sepsis-causing multiple organ dysfunctions. J Crit Rev 2016;3:31-40.

Suarez De La Rica A, Gilsanz F, Maseda E. Epidemiologic trends of sepsis in western countries. Ann Transl Med 2016;4:325.

Hall MJ, Williams SN, DeFrances CJ, Golosinskiy A. Inpatient care for septicemia or sepsis: a challenge for patients and hospitals. NCHS Data Brief 2011;62:1â€“8.

Maley JH, Mikkelsen ME. Short-term gains with long-term consequences: the evolving story of sepsis survivorship. Clin Chest Med 2016;37:367-80.

Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock. Crit Care Med 2013;41:580-637.

Ozdemir V, Hekim N. Innovation management? Orienting sepsis RandD and technology transfer towards stratified medicine. EBioMedicine J 2016;6:8-9.

Perman SM, Goyal M, Gaieski DF. Initial emergency department diagnosis and management of adult patients with severe sepsis and septic shock. Scand J Trauma Resusc Emerg Med 2012;20:41.

Ferrer R, Martin-Loeches I, Phillips G, Osborn TM, Townsend S, Dellinger RP, et al. Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program. Crit Care Med 2014;42:1749-55.

Yokota PK, Marra AR, Martino MD, Victor ES, DurÃ£o MS, Edmond MB, et al. Impact of appropriate antimicrobial therapy for patients with severe sepsis and septic shock--a quality improvement study. PLoS One 2014; 9:e104475.

Beardsley JR, Jones CM, Williamson J, Chou J, Currie-Coyoy M, Jackson T. Pharmacist involvement in a multidisciplinary initiative to reduce sepsis-related mortality. Am J Health Syst Pharm 2016;73:143-9.

Fan SL, Miller NS, Lee J, Remick DG. Diagnosing sepsis-the role of laboratory medicine. Clin Chim Acta 2016;460:203-10.

Lu J, Wang X, Chen Q, Chen M, Cheng L, Dai L, et al. The effect of early goal-directed therapy on mortality in patients with severe sepsis and septic shock: a meta-analysis. J Surg Res 2016;202:389-97.

Zhou J, Qian C, Zhao M, Yu X, Kang Y, Ma X, et al. Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China. PLoS One 2014;9:e107181.

Khwannimit B, Bhurayanontachai R. The epidemiology of, and risk factors for, mortality from severe sepsis and septic shock in a tertiary-care university hospital setting. Epidemiol Infect 2009;137:1333-41.

Aishwarya J Ramalingam. Carbapenemases and gram-negative bacteria: a review. Asian J Pharm Clin Res 2016;9:18-9.

Abhishek Pratap Singh, Usha Gupta, Saumya Das. Monitor the use of antibiotics in intensive care units with a special focus on restricted antibiotics in tertiary care hospital of India. Asian J Pharm Clin Res 2016;9:256-9.

Sep net critical care trials group. The incidence of severe sepsis and septic shock in German intensive care units: the prospective, multicentre INSEP study. Intensive Care Med 2016;42:1980-9.

Koonrangsesomboon W, Khwannimit B. Impact of positive fluid balance on mortality and length of stay in septic shock patients. Indian J Crit Care Med 2015;19:708-13.