Evaluation of critical patients with suspected sepsis in a university hospital
DOI:
https://doi.org/10.33448/rsd-v10i3.13570Keywords:
Sepsis; Antibiotic therapy; Critical patient.Abstract
Sepsis is a major cause of death in critically ill patients. Rapid and adequate antibiotic therapy is of great importance for these patients, but long-term antimicrobial treatments are undesirable because they increase resistance to antibiotics. This research aims to evaluate the clinical and epidemiological data of critically ill patients with suspected sepsis in a University Hospital in the interior of Sergipe. A prospective, quantitative and descriptive longitudinal exploratory epidemiological study was carried out in the critical units of the Hospital Universitário de Lagarto (Sergipe - Brazil). The research was approved by the institutional review board - CAAE Ethics Committee No. 16847919.8.0000.5546 - Opinion number: 3,496,684 - from the Federal University of Sergipe Foundation (UFS). 48 patients were followed through an active daily search for new suspected cases of sepsis. As for the results, 52.1% (25) of the patients were women, with a mean age of 64.29 years. The average length of hospital stay was 32.02 days. More than half of the suspected cases of sepsis, 52.1% (25) were secondary to pulmonary and respiratory tract infections and 22.9% (11) related to the urinary focus. The most prescribed antimicrobial treatments were: 21.3% Meropenem; 13.9% Piperacillin + Tazobactam; 13.1% Ceftriaxone. Of the total number of patients evaluated, 45.8% (22) died. It is concluded that patients with prolonged periods of hospitalization are more vulnerable to sepsis. As a result, the mortality rate identified is worrying and reinforces the need to early identify the factors associated with the development of sepsis and, therefore, the importance of implementing a sepsis protocol in institutions.
References
Azevedo, L. C. P & Machado, F. R. M. (2019). Sepse. (2a ed.). Atheneu: 3-13.
Barros, L. L. S., Maia, C. S. F & Monteiro, M. C. (2016). Fatores de risco associados ao agravamento de sepse em pacientes em Unidade de Terapia Intensiva. Cad. Saúde Colet, 24(4), 388-396.
Bouadma, L. et al. (2010). Use of procalcitonin to reduce patients' exposure to antibiotics in intensive care units (PRORATA trial): a multicentre randomised controlled trial. The Lancet, 375(9713), 463-474.
Costa, M. B. V., de Azevedo Ponte, K. M., da Frota, K. C., & Moreira, A. C. A. (2019). Características epidemiológicas de pacientes com sepse em unidade de terapia intensiva. Revista de Epidemiologia e Controle de Infecção, 9(4), 310-315.
Cruz, L. L & Macedo, C. C. (2016). Perfil epidemiológico da sepse em hospital de referência no interior do Ceará. Id On Line Revista Multidisciplinar e de Psicologia, 10(29), 71-99.
De Menezes, L. E. F. J. et al. (2019). Perfil epidemiológico e análise da efetividade para prevenção de óbitos de pacientes inseridos em protocolo de sepse. Revista da Sociedade Brasileira de Clínica Médica, 17(1), 25-30.
Do Nascimento Borges, A. C. et al. (2020). Epidemiology and pathophysiology of sepsis: an review. Research, Society And Development, 9(2), 187922112.
Emerson, R. W. (2015). Causation and Pearson's correlation coefficient. Journal Of Visual Impairment & Blindness, 109(3), 242-244.
Ilas, Instituto Latino Americano De Sepse. (2018). Implementação De Protocolo Gerenciado De Sepse - Protocolo Clínico. Atendimento ao paciente adulto com sepse/choque séptico. <https://www.ilas.org.br/assets/arquivos/ferramentas/protocolo-de-tratamento.pdf >.
Machado, F. R. et al. (2017). The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. The Lancet Infectious Diseases, 17(11), 1180-1189.
Machado, F. R. et al. (2016). Chegando a um consenso: vantagens e desvantagens do Sepsis 3 considerando países de recursos limitados. Rev. bras. ter. intensiva, 28(4), 361-365, Dec.
Melo, M. S. et al. (2019). Aspectos clínicos e epidemiológicos de pacientes internados com sepse em um hospital privado. Revista Enfermagem Atual InDerme, 90(28).
Pedrosa K. K. A., Oliveira S.A & Machado R.C. (2018). Validation of a care protocol for the septic patient in the Intensive Care Unit. Rev Bras Enferm; 71(3):1106-14
PDCSU. Primeiras Diretrizes Clínicas Na Saúde Suplementar. (2010). Versão preliminar / organizado por Agência Nacional de Saúde Suplementar, Associação Médica Brasileira. – Rio de Janeiro: ANS, 2010.
Rhee C., Dantes R., Epstein L., Murphy J., Seymour C & Iwashyna T. (2017). Incidence and Trends of Sepsis in USHospitals Using Clinical vs Claims Data, 2009-2014. JAMA.
Russel J. A., Rush B & Boyd J. (2018). Pathophysiology of Septic Schock. Crit Care Med.
Sakr Y., Jaschinski U., Wittebole X., Szakmany T., Lipman J & Silva San. (2018). Sepsis in Intensive Care Unit Patients: Worldwide Data From the Intensive Care over Nations Audit. Open Forum Infect Dis.
Singer, M. et al. (2016). The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA;315(8):801-10.
Santos, Am., Souza, G. R. B & Oliveira, A. M. L. (2016). Sepse em adultos na unidade de terapia intensiva: características clínicas. Arq Med Hosp Fac Cienc Med Santa Casa São Paulo. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: Volume 45, N 3.
Zonta, F. N. S. et al. (2018). Epidemiological and clinical characteristics of sepse in a public hospital of Paraná.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Phydel Palmeira Carvalho; Murilo de Jesus Porto; Jamile Fontenelle Barros; Alessana Silva Magalhães; Luann Soares Nunes; Icaro Cruz Silva; Isis Layane Silva de Abreu; Gilvania Nascimento Souza ; José Melquiades de Rezende Neto; Thiago da Silva Mendes
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
