Utility and impact of early diagnostic assessment of sepsis on mortality in an emergency department of a tertiary hospital in Lagos, Nigeria.

Autor:	Akase IE; Infectious Diseases Unit, Department of Medicine, College of Medicine, University of Lagos; Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria., Akujobi HC; Accident and Emergency Department, Lagos University Teaching Hospital, Lagos, Nigeria., Oghide O; Accident and Emergency Department, Lagos University Teaching Hospital, Lagos, Nigeria., Olusegun-Joseph AD; Department of Medicine, Lagos University Teaching Hospital; Cardiology Unit, Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria., Agbarakwe CA; Accident and Emergency Department, Lagos University Teaching Hospital, Lagos, Nigeria., Opawoye A; Department of Medicine, Lagos University Teaching Hospital, Lagos, Nigeria, Lagos, Nigeria.
Jazyk:	angličtina
Zdroj:	The Nigerian postgraduate medical journal [Niger Postgrad Med J] 2023 Jan-Mar; Vol. 30 (1), pp. 70-74.
DOI:	10.4103/npmj.npmj_190_22
Abstrakt:	Context: Currently, little is known about the timely application of clinical screening tools and blood sampling for decision-making in the management of patients with suspected sepsis in the accident and emergency units of hospitals in Nigeria. Aim: The aim of the study was to ascertain the association between the time taken for the conduct of serum lactate and blood culture investigations following a clinical suspicion of sepsis, and the mortality of patients admitted to a Nigerian tertiary hospital. Methods: Over a 6-month period (November 2021 to April 2022), 119 patients hospitalised for sepsis or septic shock at the Lagos University Teaching Hospital were followed until discharge or death. The proportion of patients whose serum lactate, serum procalcitonin and blood culture samples was taken was also determined. Predictors of mortality were determined using bivariate analysis and logistic regression. Kaplan-Meier plots were used to predict survival using sepsis diagnostic criteria. Results: Eighty (67%) of 119 sepsis patients met systemic inflammatory response syndrome or quick sequential (sepsis-related) organ failure assessment criteria. Only 3 (2.5%) patients had blood cultures and serum procalcitonin and 0 (0%) had serum lactate tests. Forty-one (34.5%) patients died, but clinical and laboratory procedures for sepsis management were not linked to death. A shorter hospital stay increased the death risk (χ 2 = 14.83, P = 0.002). Conclusion: This study revealed low compliance with sepsis care guidelines and no impact of timely clinical and laboratory procedures on sepsis mortalities. Further study is needed to explore patient care models that can improve the objective assessment and treatment of sepsis patients in emergency departments of busy tertiary hospitals. Competing Interests: None
Databáze:	MEDLINE
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