Perfil clínico y predictores de mortalidad intrahospitalaria en adultos críticamente enfermos con sepsis: revisión integradora

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i9.31905

Palabras clave:

Sepsis; Mortalidad Hospitalaria; Unidades de Cuidados Intensivos.

Resumen

La sepsis es una importante causa de muerte en los pacientes con infección, y tiene un impacto sustancial en la salud en todo el mundo. El uso de predictores de mortalidad intrahospitalaria se convierte en una alternativa para el manejo de los pacientes adultos críticos con sepsis, ya que desempeña importantes funciones diagnósticas, terapéuticas y pronósticas, reduciendo las muertes en las unidades de cuidados intensivos. Por lo tanto, este estudio tuvo como objetivo identificar en la literatura los principales predictores del pronóstico y el perfil clínico de la mortalidad en pacientes adultos ingresados en Unidades de Cuidados Intensivos (UCI) con sepsis. Se realizaron búsquedas en revistas electrónicas Medline/Pubmed, Scopus, Web of Science y LILACS, de estudios publicados entre 2017 y 2022, utilizando la pregunta guía: ¿Cuáles son los principales predictores de pronóstico y perfil clínico para la mortalidad por sepsis en pacientes adultos ingresados en Unidades de Cuidados Intensivos (UCI)? En esta revisión se incluyeron un total de 18 publicaciones, que identificaron la presencia de edad avanzada, comorbilidades, infecciones por bacterias resistentes a los antibióticos, duración prolongada de la estancia y uso de procedimientos o equipos invasivos como perfil clínico y variables predisponentes para una mayor mortalidad por sepsis. Por lo tanto, los profesionales de la salud deben conocer los impactos comunes del uso de estos predictores en los pacientes con sepsis en la unidad de cuidados intensivos, minimizando los mayores porcentajes de muerte en la población y la aparición de secuelas después del tratamiento, ayudando a guiar una atención de calidad basada en la evidencia científica.

Citas

Abe, T., Ogura, H., Shiraishi, A., Kushimoto, S., Saitoh, D., Fujishima, S., Mayumi, T., Shiino, Y., Nakada, T. A., Tarui, T., Hifumi, T., Otomo, Y., Okamoto, K., Umemura, Y., Kotani, J., Sakamoto, Y., Sasaki, J., Shiraishi, S. I., Takuma, K., Tsuruta, R., JAAM FORECAST group (2018). Characteristics, management, and in-hospital mortality among patients with severe sepsis in intensive care units in Japan: the FORECAST study. Critical care (London, England), 22(1), 322. https://doi.org/10.1186/s13054-018-2186-7.

Antequera, A., Lopez-Alcalde, J., Stallings, E., Muriel, A., Fernández Félix, B., Del Campo, R., Ponce-Alonso, M., Fidalgo, P., Halperin, A. V., Madrid-Pascual, O., Álvarez-Díaz, N., Solà, I., Gordo, F., Urrutia, G., & Zamora, J. (2021). Sex as a prognostic factor for mortality in critically ill adults with sepsis: a systematic review and meta-analysis. BMJ open, 11(9), e048982. https://doi.org/10.1136/bmjopen-2021-048982.

Auiwattanakul, S., Chittawatanarat, K., Chaiwat, O., Morakul, S., Kongsayreepong, S., Ungpinitpong, W., Yutthakasemsunt, S., & Buranapin, S. (2019). Effects of nutrition factors on mortality and sepsis occurrence in a multicenter university-based surgical intensive care unit in Thailand (THAI-SICU study). Nutrition (Burbank, Los Angeles County, Calif.), 58, 94–99. https://doi.org/10.1016/j.nut.2018.06.021.

Boonmee, P., Ruangsomboon, O., Limsuwat, C., & Chakorn, T. (2020). Predictors of Mortality in Elderly and Very Elderly Emergency Patients with Sepsis: A Retrospective Study. The western journal of emergency medicine, 21(6), 210–218. https://doi.org/10.5811/westjem.2020.7.47405.

Bouza, C., & López-Cuadrado, T. (2019). Epidemiology and Trends of Sepsis in Young Adults Aged 20-44 Years: A Nationwide Population-Based Study. Journal of clinical medicine, 9(1), 77. https://doi.org/10.3390/jcm9010077.

Campanelli, F., Soudry-Faure, A., Avondo, A., Roudaut, J. B., Quenot, J. P., Ray, P., & Charles, P. E. (2022). Septic patients without obvious signs of infection at baseline are more likely to die in the ICU. BMC infectious diseases, 22(1), 205. https://doi.org/10.1186/s12879-022-07210-y.

Caraballo, C., Ascuntar, J., Hincapié, C., Restrepo, C., Bernal, E., & Jaimes, F. (2019). Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia. Revista Brasileira de terapia intensiva, 31(1), 47–56. https://doi.org/10.5935/0103-507X.20190011.

D'Onofrio, V., Meersman, A., Vijgen, S., Cartuyvels, R., Messiaen, P., & Gyssens, I. C. (2020). Risk Factors for Mortality, Intensive Care Unit Admission, and Bacteremia in Patients Suspected of Sepsis at the Emergency Department: A Prospective Cohort Study. Open forum infectious diseases, 8(1), ofaa594. https://doi.org/10.1093/ofid/ofaa594.

Fang, F., Zhang, Y., Tang, J., Lunsford, L. D., Li, T., Tang, R., He, J., Xu, P., Faramand, A., Xu, J., & You, C. (2019). Association of Corticosteroid Treatment With Outcomes in Adult Patients With Sepsis: A Systematic Review and Meta-analysis. JAMA internal medicine, 179(2), 213–223. https://doi.org/10.1001/jamainternmed.2018.5849.

Fleischmann-Struzek, C., Mellhammar, L., Rose, N., Cassini, A., Rudd, K. E., Schlattmann, P., Allegranzi, B., & Reinhart, K. (2020). Incidence and mortality of hospital- and ICU-treated sepsis: results from an updated and expanded systematic review and meta-analysis. Intensive care medicine, 46(8), 1552–1562. https://doi.org/10.1007/s00134-020-06151-x.

Fortini, A., Faraone, A., Cappugi, C., Monsacchi, L., Sbaragli, S., & Beltrame, C. (2021). Prevalence and in-hospital outcome of patients with sepsis in an internal medicine ward. La Clinica terapeutica, 172(2), 134–137. https://doi.org/10.7417/CT.2021.2300.

Garg, R., Tellapragada, C., Shaw, T., Eshwara, V. K., Shanbhag, V., Rao, S., Virk, H. S., Varma, M., & Mukhopadhyay, C. (2022). Epidemiology of sepsis and risk factors for mortality in intensive care unit: a hospital based prospective study in South India. Infectious diseases (London, England), 54(5), 325–334. https://doi.org/10.1080/23744235.2021.2017475.

Haas, L., Boumendil, A., Flaatten, H., Guidet, B., Ibarz, M., Jung, C., Moreno, R., Morandi, A., Andersen, F. H., Zafeiridis, T., Walther, S., Oeyen, S., Leaver, S., Watson, X., Boulanger, C., Szczeklik, W., Schefold, J. C., Cecconi, M., Marsh, B., Joannidis, M., … VIP2 study group (2021). Frailty is associated with long-term outcome in patients with sepsis who are over 80 years old: results from an observational study in 241 European ICUs. Age and ageing, 50(5), 1719–1727. https://doi.org/10.1093/ageing/afab036.

Hu, T., Lv, H., & Jiang, Y. (2021). The association between four scoring systems and 30-day mortality among intensive care patients with sepsis: a cohort study. Scientific reports, 11(1), 11214. https://doi.org/10.1038/s41598-021-90806-2.

Markwart, R., Saito, H., Harder, T., Tomczyk, S., Cassini, A., Fleischmann-Struzek, C., Reichert, F., Eckmanns, T., & Allegranzi, B. (2020). Epidemiology and burden of sepsis acquired in hospitals and intensive care units: a systematic review and meta-analysis. Intensive care medicine, 46(8), 1536–1551. https://doi.org/10.1007/s00134-020-06106-2.

Mendes, K. D. S., Silveira, R. C. D. C. P., & Galvão, C. M. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto-enfermagem, 17, 758-764.

Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS medicine, 6(7), e1000097. https://doi.org/10.1371/journal.pmed.1000097.

Morkar, D. N., Dwivedi, M., & Patil, P. (2022). Comparative Study of Sofa, Apache Ii, Saps Ii, as a Predictor of Mortality in Patients of Sepsis Admitted in Medical ICU. The Journal of the Association of Physicians of India, 70(4), 11–12.

Sivayoham, N., Hussain, A. N., Shabbo, L., & Christie, D. (2021). An observational cohort study of the performance of the REDS score compared to the SIRS criteria, NEWS2, CURB65, SOFA, MEDS and PIRO scores to risk-stratify emergency department suspected sepsis. Annals of medicine, 53(1), 1863–1874. https://doi.org/10.1080/07853890.2021.1992495.

Sousa, L. M. M. De, Firmino, C. F., Marques-Vieira, C. M. A., Severino, S. S. P., & Pestana, H. C. F. C. (2018). Revisões da literatura científica: tipos, métodos e aplicações em enfermagem. Revista Portuguesa de Enfermagem de Reabilitação, 1(1), 45–54. https://doi.org/10.33194/RPER.2018.V1.N1.07.4391.

Tonai, M., Shiraishi, A., Karumai, T., Endo, A., Kobayashi, H., Fushimi, K., & Hayashi, Y. (2022). Hospital-onset sepsis and community-onset sepsis in critical care units in Japan: a retrospective cohort study based on a Japanese administrative claims database. Critical care (London, England), 26(1), 136. https://doi.org/10.1186/s13054-022-04013-0.

Vélez, J. W., Aragon, D. C., Donadi, E. A., & Carlotti, A. (2022). Risk factors for mortality from sepsis in an intensive care unit in Ecuador: A prospective study. Medicine, 101(11), e29096. https://doi.org/10.1097/MD.0000000000029096.

Vucelić, V., Klobučar, I., Đuras-Cuculić, B., Gverić Grginić, A., Prohaska-Potočnik, C., Jajić, I., Vučičević, Ž., & Degoricija, V. (2020). Sepsis and septic shock - an observational study of the incidence, management, and mortality predictors in a medical intensive care unit. Croatian medical journal, 61(5), 429–439. https://doi.org/10.3325/cmj.2020.61.429.

Xu, F., Zhang, L., Huang, T., Yang, R., Han, D., Zheng, S., Feng, A., Huang, L., Yin, H., & Lyu, J. (2022). Influence of ambulatory blood pressure-related indicators within 24 h on in-hospital death in sepsis patients. International journal of medical sciences, 19(3), 460–471. https://doi.org/10.7150/ijms.67967.

Publicado

03/07/2022

Cómo citar

CRUZ, D. A. .; SILVA, P. V. S. .; SILVA, K. M. P. da; NASCIMENTO , I. R. do .; ARAÚJO , B. N. V. de .; SILVA, I. T. da; COSTA, I. S. .; SOUSA, G. P. de .; SOUSA, L. N. de .; SOUSA, J. N. M. de . Perfil clínico y predictores de mortalidad intrahospitalaria en adultos críticamente enfermos con sepsis: revisión integradora. Research, Society and Development, [S. l.], v. 11, n. 9, p. e18011931905, 2022. DOI: 10.33448/rsd-v11i9.31905. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/31905. Acesso em: 22 dic. 2024.

Número

Sección

Ciencias de la salud