Factors relating to mortality in septic patients in Vietnamese intensive care units from a subgroup analysis of MOSAICS II study.

Autor: Do SN; Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, 100000, Vietnam., Luong CQ; Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam. luongquocchinh@gmail.com.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam. luongquocchinh@gmail.com.; Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, 100000, Vietnam. luongquocchinh@gmail.com., Pham DT; Department of Nutrition and Food Safety, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam., Nguyen MH; Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, 410000, Vietnam., Nguyen NT; Department of Intensive Care and Poison Control, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, 180000, Vietnam., Huynh DQ; Intensive Care Department, Cho Ray Hospital, Ho Chi Minh City, 700000, Vietnam.; Department of Critical Care, Emergency Medicine and Clinical Toxicology, Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, 700000, Vietnam., Hoang QTA; Emergency Department, Hue Central General Hospital, Hue City, Thua Thien Hue, 530000, Vietnam., Dao CX; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.; Department of Intensive Care, Bach Mai Hospital, Hanoi, 100000, Vietnam., Le TM; Intensive Care Unit, 115 People's Hospital, Ho Chi Minh City, 700000, Vietnam., Bui HN; Intensive Care Unit, Bai Chay General Hospital, Quang Ninh, 200000, Vietnam., Nguyen HT; Intensive Care Unit, Da Nang Hospital, Da Nang, 550000, Vietnam., Hoang HB; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.; Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, 100000, Vietnam., Le TTP; Intensive Care Unit, Dong Da General Hospital, Hanoi, 100000, Vietnam., Nguyen LTB; Intensive Care Unit, Saint Paul General Hospital, Hanoi, 100000, Vietnam., Duong PT; Intensive Care Unit, Can Tho Central General Hospital, Can Tho, 900000, Vietnam., Nguyen TD; Intensive Care Unit, Vinmec Times City International Hospital, Hanoi, 100000, Vietnam., Vu YH; Intensive Care Unit, Da Nang Hospital, Da Nang, 550000, Vietnam.; Intensive Care Unit, Thai Nguyen Central General Hospital, Thai Nguyen, 250000, Vietnam., Pham GTT; Emergency Department, Thanh Nhan General Hospital, Hanoi, 100000, Vietnam., Van Bui T; Department of Intensive Care and Poison Control, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, 180000, Vietnam., Pham TTN; Intensive Care Department, Cho Ray Hospital, Ho Chi Minh City, 700000, Vietnam.; Department of Critical Care, Emergency Medicine and Clinical Toxicology, Faculty of Medicine, Ho Chi Minh City University of Medicine and Pharmacy, Ho Chi Minh City, 700000, Vietnam., Hoang HT; Intensive Care Unit, Hue Central General Hospital, Hue City, Thua Thien Hue, 530000, Vietnam.; Department of Emergency and Critical Care Medicine, Faculty of Medicine, Hue University of Medicine and Pharmacy, Hue City, Thua Thien Hue, 530000, Vietnam., Van Bui C; Department of Intensive Care, Bach Mai Hospital, Hanoi, 100000, Vietnam., Nguyen NM; Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, 100000, Vietnam., Bui GTH; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.; Department of Intensive Care, Bach Mai Hospital, Hanoi, 100000, Vietnam., Vu TD; Intensive Care Unit, 115 People's Hospital, Ho Chi Minh City, 700000, Vietnam., Le ND; Intensive Care Unit, Da Nang Hospital, Da Nang, 550000, Vietnam., Tran TH; Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, 100000, Vietnam., Nguyen TQ; Intensive Care Unit, Vinmec Times City International Hospital, Hanoi, 100000, Vietnam., Le VH; Intensive Care Unit, Thai Nguyen Central General Hospital, Thai Nguyen, 250000, Vietnam., Van Nguyen C; Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam., McNally BF; Emory University Rollins School of Public Health, Atlanta, GA, 30322, USA.; Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, 30322, USA., Phua J; FAST and Chronic Programmes, Alexandra Hospital, National University Health System, Singapore, 159964, Singapore.; Division of Respiratory and Critical Care Medicine, Department of Medicine, National University Health System, Singapore, 119228, Singapore., Nguyen AD; Center for Emergency Medicine, Bach Mai Hospital, 78 Giai Phong road, Phuong Mai ward, Dong Da district, Hanoi, 100000, Vietnam.; Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, 100000, Vietnam.
Jazyk: angličtina
Zdroj: Scientific reports [Sci Rep] 2021 Sep 23; Vol. 11 (1), pp. 18924. Date of Electronic Publication: 2021 Sep 23.
DOI: 10.1038/s41598-021-98165-8
Abstrakt: Sepsis is the most common cause of in-hospital deaths, especially from low-income and lower-middle-income countries (LMICs). This study aimed to investigate the mortality rate and associated factors from sepsis in intensive care units (ICUs) in an LMIC. We did a multicenter cross-sectional study of septic patients presenting to 15 adult ICUs throughout Vietnam on the 4 days representing the different seasons of 2019. Of 252 patients, 40.1% died in hospital and 33.3% died in ICU. ICUs with accredited training programs (odds ratio, OR: 0.309; 95% confidence interval, CI 0.122-0.783) and completion of the 3-h sepsis bundle (OR: 0.294; 95% CI 0.083-1.048) were associated with decreased hospital mortality. ICUs with intensivist-to-patient ratio of 1:6 to 8 (OR: 4.533; 95% CI 1.621-12.677), mechanical ventilation (OR: 3.890; 95% CI 1.445-10.474) and renal replacement therapy (OR: 2.816; 95% CI 1.318-6.016) were associated with increased ICU mortality, in contrast to non-surgical source control (OR: 0.292; 95% CI 0.126-0.678) which was associated with decreased ICU mortality. Improvements are needed in the management of sepsis in Vietnam such as increasing resources in critical care settings, making accredited training programs more available, improving compliance with sepsis bundles of care, and treating underlying illness and shock optimally in septic patients.
(© 2021. The Author(s).)
Databáze: MEDLINE
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