Epidemiology and outcome of sepsis in a tertiary-care hospital in a developing country

Abstract

Sepsis continues to have a substantial mortality and morbidity despite advances in the diagnosis and management of this condition. We retrospectively analysed hospital charts of patients diagnosed to have sepsis between January 2002 and June 2003. Demographic characteristics of patients, microbiological findings and predictors of survival were evaluated. Sixty-nine sepsis episodes that occurred in 63 patients were analysed. The most common underlying diseases were hypertension, malignancies and diabetes mellitus. Renal insufficiency, respiratory distress and disseminated intravascular coagulation developed in 52.2, 30.4 and 30.4% of the episodes respectively; 47.7% of the blood cultures yielded an organism. Gram-negative bacteria were the predominant microorganisms (65.9%). Fifty-five patients (87.3%) died. Mechanical ventilation and underlying renal disease were significant determinants of mortality. In conclusion, Gram-negative bacteria remain the major pathogens in sepsis. The mortality remains very high, and a change in the clinical approach to the septic patient should be employed to improve the outcome.

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

“…Although most of the world's population lives in developing countries, very few studies assessing the frequency and mortality of sepsis in these nations are available. Mortality reports from Pakistan, Thailand, and Turkey range from 80 to 92% for severe sepsis (6)(7)(8). These and other publications suggest that mortality due to sepsis is much higher in developing countries than in developed ones (6)(7)(8)(9).…”

“…These conditions are generally associated with multiple organ failure as final outcome (1)(2)(3)(4)(5). Over the past 30 years, the worldwide incidence of sepsis has increased by 13.7% per year (1)(2)(3)(4)(5).…”

“…These conditions are generally associated with multiple organ failure as final outcome (1)(2)(3)(4)(5). Over the past 30 years, the worldwide incidence of sepsis has increased by 13.7% per year (1)(2)(3)(4)(5). It is therefore estimated that more than 18 million people suffer from sepsis each year and more than five million of them die (1)(2)(3)(4)(5).…”

“…Over the past 30 years, the worldwide incidence of sepsis has increased by 13.7% per year (1)(2)(3)(4)(5). It is therefore estimated that more than 18 million people suffer from sepsis each year and more than five million of them die (1)(2)(3)(4)(5). This increase is arguably due to increasing numbers of people aged over 65 years (60% of septic patients are more than 65 years old), to more frequent diseases and therapies causing immunosuppression, and to widespread use of diagnostic and/or therapeutic invasive procedures.…”

“…Despite important advances in the understanding of the pathophysiology of sepsis, its overall mortality is greater than 30% (1)(2)(3)(4)(5). These data come from studies carried out in developed countries.…”