Evaluation of critical patients with suspected sepsis in a university hospital

Authors

DOI:

https://doi.org/10.33448/rsd-v10i3.13570

Keywords:

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.

Published

20/03/2021

How to Cite

CARVALHO, P. P. .; PORTO, M. de J. .; BARROS, J. F. .; MAGALHÃES, A. S. .; NUNES, L. S. .; SILVA, I. C. .; ABREU, I. L. S. de .; SOUZA , G. N. .; REZENDE NETO, J. M. de; MENDES, T. da S. . Evaluation of critical patients with suspected sepsis in a university hospital. Research, Society and Development, [S. l.], v. 10, n. 3, p. e39410313570, 2021. DOI: 10.33448/rsd-v10i3.13570. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/13570. Acesso em: 13 apr. 2021.

Issue

Section

Health Sciences