Association between early manifestations of infection or sepsis and prognosis in a high complexity hospital in the city of Medellín.

OBJECTIVE: To identify the first symptoms and signs of patients with suspected infection or sepsis and their association with the composite outcome of admission to the Intensive Care Unit (ICU) or mortality. DESIGN: Prospective cohort study between June 2019 and March 2020. SETTING: Hospital Universitario San Vicente Fundación, Colombia. PATIENTS: Over 18 years of age with suspicion or confirmation of sepsis, which required hospitalization. INTERVENTIONS: None. MAIN VARIABLES OF INTEREST: Symptoms and signs associated with infection, with their time of evolution, specified in the study. RESULTS: From 1005 eligible patients, 261 were included. After multivariable adjustment with a logistic regression model, the main factors for ICU admission or mortality were heart rate (OR 1.04 with 95% CI 1.04-3.7), respiratory rate (OR 1.19 with 95% CI 1.0-1.4) and capillary refill time (OR 3.4 with 95% CI 1.9-6.1). CONCLUSIONS: Heart rate, respiratory rate, and capillary refill may behave as early predictors of ICU admission and mortality in cases of sepsis.

Fear, infection and compassion: social representations of tuberculosis in Medellin, Colombia, 2007.

OBJECTIVE: To identify and analyse the social representations (SRs) of tuberculosis (TB) among three groups of people in Medellin, Colombia, with the purpose of contributing to improvements in TB treatment and control programme activities. METHODS: Cross-sectional study using free word association and evocative analysis techniques in 1049 persons within a structural SR framework. RESULTS: The terms 'cough', 'contagion', 'illness' and 'fear' were found to be components of the central core in the three groups. In the peripheral system, 'rejection' and 'treatment' were considered modifiable factors. Text analysis showed that 'fear' and 'compassion' are associated with evocations among patients and their relatives, 'contagion' among lay people and 'isolation' among health care personnel. DISCUSSION: Fear of infection may have a negative effect on relationships with patients, health care activities, treatment surveillance and family support for patients. A better understanding of patient beliefs and their family environment can improve treatment quality and adherence in the city.