Epidemiology of sepsis in intensive care units in Turkey: a multicenter, point-prevalence study

Autor: Volkan Hancı, Perihan Ergin Ozcan, Seyda Efsun Ozgunay, Halil Erkan Sayan, KUBILAY DEMIRAG, Mustafa Kemal Arslantaş, Hayrettin Daşkaya, Ender Gedik, NEDIM ÇEKMEN, Evren Şentürk, Süheyla Ünver, Günseli Orhun, Nihan Yapici, Necmettin Unal
Přispěvatelé: Baykara, Nur, Akalin, Halis, Arslantas, Mustafa Kemal, Hanci, Volkan, Caglayan, Cigdem, Kahveci, Ferda, Demirag, Kubilay, Baydemir, Canan, Unal, Necmettin, Ege Üniversitesi, Baykara, N, Akalin, H, Arslantas, MK, Hanci, V, Caglayan, C, Kahveci, F, Demirag, K, Baydemir, C, Unal, N, Sakarya Üniversitesi/Tıp Fakültesi/Cerrahi Tıp Bilimleri Bölümü, Palabıyık, Onur
Rok vydání: 2017
Předmět:
Male
Point prevalence
Turkey
Organ Dysfunction Scores
Prevalence
Critical Care and Intensive Care Medicine
DEFINITIONS
0302 clinical medicine
Epidemiology
HOSPITAL MORTALITY
INFECTION
030212 general & internal medicine
APACHE
OUTCOMES
Mortality rate
lcsh:Medical emergencies. Critical care. Intensive care. First aid
Middle Aged
Shock
Septic
PATIENT MORTALITY
Systemic Inflammatory Response Syndrome
Intensive Care Units
Shock (circulatory)
Female
medicine.symptom
ORGANISMS
Monte Carlo Method
Acinetobacter Infections
medicine.medical_specialty
Carbapenem resistance
Statistics
Nonparametric
Sepsis
03 medical and health sciences
Intensive care
Internal medicine
medicine
Humans
Pseudomonas Infections
Aged
Septic shock
business.industry
Research
SEPTIC SHOCK
030208 emergency & critical care medicine
lcsh:RC86-88.9
medicine.disease
TRENDS
Klebsiella Infections
Systemic inflammatory response syndrome
Cross-Sectional Studies
Logistic Models
STATES
RISK-FACTORS
business
Zdroj: Critical Care
Critical Care, Vol 22, Iss 1, Pp 1-14 (2018)
ISSN: 1466-609X
Popis: WOS: 000430617700001
PubMed ID: 29656714
Background: The prevalence and mortality of sepsis are largely unknown in Turkey, a country with high antibiotic resistance. A national, multicenter, point-prevalence study was conducted to determine the prevalence, causative microorganisms, and outcome of sepsis in intensive care units (ICUs) in Turkey. Methods: A total of 132 ICUs from 94 hospitals participated. All patients (aged > 18 years) present at the participating ICUs or admitted for any duration within a 24-h period (08:00 on January 27, 2016 to 08:00 on January 28, 2016) were included. The presence of systemic inflammatory response syndrome (SIRS), severe sepsis, and septic shock were assessed and documented based on the consensus criteria of the American College of Chest Physicians and Society of Critical Care Medicine (SEPSIS-I) in infected patients. Patients with septic shock were also assessed using the SEPSIS-III definitions. Data regarding demographics, illness severity, comorbidities, microbiology, therapies, length of stay, and outcomes (dead/alive during 30 days) were recorded. Results: Of the 1499 patients included in the analysis, 237 (15.8%) had infection without SIRS, 163 (10.8%) had infection with SIRS, 260 (17.3%) had severe sepsis without shock, and 203 (13.5%) had septic shock. The mortality rates were higher in patients with severe sepsis (55.7%) and septic shock (70.4%) than those with infection alone (24.8%) and infection + SIRS (31.2%) (p < 0.001). According to SEPSIS-III, 104 (6.9%) patients had septic shock (mortality rate, 75.9%). The respiratory system (71.6%) was the most common site of infection, and Acinetobacter spp. (33.7%) were the most common isolated pathogen. Approximately, 74.9%, 39.1%, and 26.5% of Acinetobacter, Klebsiella, and Pseudomonas spp. isolates, respectively, were carbapenem-resistant, which was not associated with a higher mortality risk. Age, acute physiology and chronic health evaluation II score at ICU admission, sequential organ failure assessment score on study day, solid organ malignancy, presence of severe sepsis or shock, Candida spp. infection, renal replacement treatment, and a nurse-to-patient ratio of 1: 4 (compared with a nurse-to-patient ratio of 1:2) were independent predictors of mortality in infected patients. Conclusions: A high prevalence of sepsis and an unacceptably high mortality rate were observed in Turkish ICUs. Although the prevalence of carbapenem resistance was high in Turkish ICUs, it was not associated with a higher risk for mortality.
Databáze: OpenAIRE
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