Characteristics of Adult Sepsis Patients in the Intensive Care Units in a Tertiary Hospital in Jordan: An Observational Study

Abstract

Sepsis is a global health issue that is commonly encountered in the intensive care unit (ICU) and is associated with high morbidity and mortality. Available data regarding sepsis in low- and middle-income countries (LMIC) is lacking compared to higher income countries, especially using updated sepsis definitions. The lack of recent data on sepsis in Jordan prompted us to investigate the burden of sepsis among Jordanian ICU patients. We conducted a prospective cohort study at Jordan University Hospital, a tertiary teaching hospital in the capital, Amman. All adult patients admitted to the adult ICUs between June 2020 and January 2021 were included in the study. Patients’ clinical and demographic data, comorbidities, ICU length of stay (LOS), medical interventions, microbiological findings, and mortality rate were studied. Descriptive and inferential statistics were used to analyse data from patients with and without sepsis. We observed 194 ICU patients during the study period; 45 patients (23.3%) were diagnosed with sepsis using the Sepsis-3 criteria. Mortality rate and median ICU LOS in patients who had sepsis were significantly higher than those in other ICU patients (mortality rate, 57.8% vs. 6.0%, p value < 0.001, resp., and LOS 7 days vs. 4 days, p value < 0.001, resp.). Additionally, sepsis patients had a higher combined number of comorbidities (2.27 ± 1.51 vs. 1.27 ± 1.09, p value < 0.001). The use of mechanical ventilation, endotracheal intubation, and blood transfusions were all significantly more common among sepsis patients. A causative organism was isolated in 68.4% of sepsis patients with a prevalence of Gram-negative bacteria in 77.1% of cases. While the occurrence of sepsis in the ICU in Jordan is comparable to other regions in the world, the mortality rate of sepsis patients in the ICU remains high. Further studies from LMIC are required to reveal the true burden of sepsis globally.

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“…According to the Agency for Health Care Research and Quality, the average hospital stay is 4.5 days worldwide [ 47 ]. However, previous Jordanian studies show that the LoS is much higher [ 13 , 48 , 49 ]. In the present study findings, the mean length of ICU and hospital stay was high compared to some studies [ 50 , 51 ] and low compared to other studies [ 43 , 52 ].…”

Sepsis among Patients Admitted to the Intensive Care Unit of a Tertiary Care Centre

“… 9 An observational previous study showed diabetes as the most prevalent comorbidities, which is 47.9%. 9 In our study, hypertension was the most common comorbidity followed by diabetes mellitus and COPD. A similar finding was present in a study conducted in India.…”

“…A previous observational study showed that the mortality rate of patients with sepsis was 57.80% while another descriptive observational study in India showed a mortality rate of 42.2%. 9 Out of 278 patients, 87 (31.29%) were discharged normally and 60 (21.58%) died during their hospital stay. In a previous study, the mortality rate was 36.5%, a similar study showed 35.2% and 39.3% mortality.…”

Sepsis among Adults Admitted to Intensive Care Unit of a Tertiary Care Centre

“… 4 In a Colombian city, the prevalence was found to be 44%, 6 and in Jordan, it was 23.3%. 7 The differences in the prevalence were due to differences in setting, differences in the diagnostic criteria used and population.…”