Characteristics and outcomes of patients with community-acquired and hospital-acquired sepsis.

Autor: Westphal GA; Centro Hospitalar Unimed Joinville - Joinville (SC), Brasil., Pereira AB; Centro Hospitalar Unimed Joinville - Joinville (SC), Brasil., Fachin SM; Centro Hospitalar Unimed Joinville - Joinville (SC), Brasil., Barreto ACC; Universidade da Região de Joinville - Joinville (SC), Brasil., Bornschein ACGJ; Universidade da Região de Joinville - Joinville (SC), Brasil., Caldeira Filho M; Centro Hospitalar Unimed Joinville - Joinville (SC), Brasil., Koenig Á; Centro Hospitalar Unimed Joinville - Joinville (SC), Brasil.
Jazyk: Portuguese; English
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2019 Jan-Mar; Vol. 31 (1), pp. 71-78.
DOI: 10.5935/0103-507X.20190013
Abstrakt: Objective: To compare the clinical characteristics and outcomes of patients with community-acquired and hospital-acquired sepsis.
Methods: This is a retrospective cohort study that included all patients with a diagnosis of sepsis detected between January 2010 and December 2015 at a private hospital in southern Brazil. Outcomes (mortality, intensive care unit and hospital lengths of stay) were measured by analyzing electronic records.
Results: There were 543 hospitalized patients with a diagnosis of sepsis, with a frequency of 90.5 (85 to 105) cases/year. Of these, 319 (58%) cases were classified as hospital-acquired sepsis. This group exhibited more severe disease and had a larger number of organ dysfunctions, with higher hospital [8 (8 - 10) versus 23 (20 - 27) days; p < 0.001] and intensive care unit [5 (4 - 7) versus 8.5 (7 - 10); p < 0.001] lengths of stay and higher in-hospital mortality (30.7% versus 15.6%; p < 0.001) than those with community-acquired sepsis. After adjusting for age, APACHE II scores, and hemodynamic and respiratory dysfunction, hospital-acquired sepsis remained associated with increased mortality (OR 1.96; 95%CI 1.15 - 3.32, p = 0.013).
Conclusion: The present results contribute to the definition of the epidemiological profile of sepsis in the sample studied, in which hospital-acquired sepsis was more severe and was associated with higher mortality.
Databáze: MEDLINE
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