RESUMO: INTRODUÇÃO: Existe uma grande prevalência de manifestações extra-intestinais(MEI) em portadores de doença de

BackgroundSepsis is a prevalent disease worldwide and still exhibits high rates of mortality. In the last years, many interventions aiming a positive impact on sepsis evolution have been studied. One of the main is the use of managed care protocols (sepsis bundles), which consist in systematization of diagnosis and treatment, such as standardization of antibiotics, collection of specific tests (cultures, lactate), and fluid replacement. Some studies have shown a reduction in hospital costs and lower mortality with the use of these tools. In the present study, we evaluated the impact of a sepsis bundle in wards of a tertiary hospital.MethodsOne hundred sixty-seven patients were retrospectively studied. The intervention was called “3-h bundle” and consisted of collecting lactate and cultures, start broad-spectrum antibiotics in the first hour of sepsis diagnosis, and volume replacement with crystalloid if hypotension or lactate ≥2 mmol/L.ResultsThe overall mortality was 31.1%. Individuals who received the 3-h bundle showed a 44% lower mortality in comparison with who did not (25.6 vs. 45.7%; p = 0.01). Furthermore, the use of the sepsis bundle was independently correlated with lower mortality (OR = 0.175; CI = 0.04–0.64; p = 0.009). Therefore, a lower need for ICU admission and shorter length of stay in these units were observed in patients who received the intervention.ConclusionThe use of a sepsis protocol with systematic care in wards was associated with lower mortality, less need for ICU admission and shorter stay on these units.Electronic supplementary materialThe online version of this article (doi:10.1186/s40560-017-0231-2) contains supplementary material, which is available to authorized users.

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In order to analyze the epidemiological characteristics of hospitalizations generated by adverse drug reactions and drug intoxication (DI) in the state of Rio de Janeiro between 2014 and 2019, a retrospective study was carried out, using the MicrodataSUS library for the acquisition of micro data from Health Information Systems followed by subsequent statistical analysis performed by the R Commander® software. Such hospitalizations were generated mostly by DI (p<0,001) with a predominance of cases in males (64.21%), mainly in a medical emergency (81.15%) with priority demands for care by psychiatry (48.16%) and clinical medical (36.93%) and very low mortality (97.1%). The individual's age does not influence the number of days spent in the hospital. On the other hand, the greater the number of hospitalized days, the greater the total amounts spent (p<0,001). The need to adopt more effective pharmacovigilance programs is evident in order to avoid and/or reduce harm to the health of individuals, as well as to reduce demands and avoidable expenses.

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