Characteristics and outcomes of patients with community-acquired and hospital-acquired sepsis
| Autor: | Álvaro Koenig, Milton Caldeira Filho, Ana Carolina Gern Junqueira Bornschein, Glauco Adrieno Westphal, Silvia Maria Fachin, Aline Braz Pereira, Ana Carolina Caldara Barreto |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Sepsis mortality Hospital mortality Critical Care and Intensive Care Medicine Hospitals Private Sepsis Cohort Studies 03 medical and health sciences 0302 clinical medicine Medicine Humans 030212 general & internal medicine Hospital Mortality Mortality APACHE Aged Retrospective Studies Gynecology Cross Infection business.industry 030208 emergency & critical care medicine General Medicine Original Articles Community-acquired infections Length of Stay Middle Aged medicine.disease Iatrogenic disease Intensive Care Units Female business Brazil |
| Zdroj: | Revista Brasileira de Terapia Intensiva |
| ISSN: | 1982-4335 0103-507X |
| Popis: | To compare the clinical characteristics and outcomes of patients with community-acquired and hospital-acquired sepsis.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.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; p0.001] and intensive care unit [5 (4 - 7) versus 8.5 (7 - 10); p0.001] lengths of stay and higher in-hospital mortality (30.7% versus 15.6%; p0.001) 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).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.Comparar as características clínicas e os desfechos de pacientes com sepse adquirida na comunidade ou no hospital.Trata-se de estudo retrospectivo de coorte, que incluiu todos os pacientes com diagnóstico de sepse detectada entre janeiro de 2010 e dezembro de 2015 em um hospital privado localizado na Região Sul do Brasil. Os desfechos (mortalidade, tempo de permanência na unidade de terapia intensiva e no hospital) foram avaliados por meio da análise dos registros eletrônicos.Foram hospitalizados, no total, 543 pacientes com diagnóstico de sepse, com frequência de 90,5 (85 a 105) casos por ano. Destes, 319 (58%) casos foram classificados como sepse adquirida no hospital. Este grupo apresentava doença mais grave e tinha um maior número de disfunções de órgãos, assim como teve um tempo maior de permanência no hospital [8 (8 - 10) versus 23 (20 - 27) dias; p0,001] e na unidade de terapia intensiva [5 (4 - 7) versus 8,5 (7 - 10); p0,001] do aqueles que apresentavam sepse adquirida na comunidade. Após ajustar quanto à idade, escore APACHE II e disfunção hemodinâmica e respiratória, a sepse adquirida no hospital persistiu associada com maior mortalidade (OR 1,96; IC95% 1,15 - 3,32, p = 0,013).Nossos resultados contribuem para a definição do perfil epidemiológico da sepse na amostra estudada, na qual a sepse adquirida no hospital foi mais grave e associada com mortalidade mais alta. |
| Databáze: | OpenAIRE |
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