[An epidemiological study of sepsis in Intensive Care Units: Sepsis Brazil study].

Autor:	Sales Júnior JA; Hospital de Clínicas de Niterói., David CM; UTI, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro., Hatum R; Hospital São Lucas, Rio de Janeiro., Souza PC; UTI, Hospital de Clínicas de Niterói., Japiassú A; UTI, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro., Pinheiro CT; UTI, Hospital de Clínicas de Porto Alegre., Friedman G; UTI, Complexo Hospitalar Santa Casa Porto Alegre-Rio Grande do Sul., Silva OB; UTI, Hospital Santa Joana, Recife., Dias MD; UTI, Hospital Nove de Julho, São Paulo., Koterba E; H. São Camilo, São Paulo., Dias FS; UTI, Hospital São Lucas, PUC, Rio Grande do Sul., Piras C; UTI, Hospital São Lucas, Vitória, ES., Luiz RR; Universidade Federal do Rio de Janeiro.
Jazyk:	portugalština
Zdroj:	Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2006 Mar; Vol. 18 (1), pp. 9-17.
Abstrakt:	Background and Objectives: Sepsis represents the major cause of death in the ICUs all over the world. Many studies have shown an increasing incidence over time and only a slight reduce in mortality. Many new treatment strategies are arising and we should define the incidence and features of sepsis in Brazil. Methods: Prospective cohort study in sixty-five hospitals all over Brazil. The patients who were admitted or who developed sepsis during the month of September, 2003 were enrolled. They were followed until the 28th day and/or until their discharge. The diagnoses were made in accordance to the criteria proposed by ACCP/SCCM. It were evaluated demographic features, APACHE II score, SOFA (Sepsis-related Organ Failure Assessment) score, mortality, sources of infections, microbiology, morbidities and length of stay (LOS). Results: Seventy-five ICUs from all regions of Brazil took part in the study.3128 patients were identified and 521 (16.7%) filled the criteria of sepsis, severe sepsis or septic shock. Mean age was 61.7 (IQR 39-79), 293 (55.7%) were males, and the overall 28-day mortality rate was 46.6%. Average APACHE II score was 20 and SOFA score on the first day was 7 (IQR 4-10). SOFA score in the mortality group was higher on day 1 (8, IQR 5-11), and had increased on day 3 (9, IQR 6-12). The mortality rate for sepsis, severe sepsis and septic shock was 16.7%, 34.4% and 65.3%, respectively. The average LOS was 15 days (IQR 5-22). The two main sources of infection were the respiratory tract (69%) and the abdomen one (23.1%). Gram-negative bacilli were more prevalent (40.1%). Gram-positive cocci were identified in 32.8% and fungi infections in 5%. Mechanical ventilation was observed in 82.1% of the patients, Swan-Ganz catheter in 18.8%, vasopressors in 66.2% and hemotransfusion in 44.7%. Conclusions: It was observed a high mortality of sepsis in the ICUs in Brazil. The high frequency of septic shock demonstrated a group at high risk of death. In order to have a better use of the resources and reduce in mortality during the next 5 years, it is very important to identify our specific features related to this syndrome.
Databáze:	MEDLINE
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