Assessment of clinical and epidemiological characteristics of patients with and without sepsis in intensive care units of a tertiary hospital.

OBJECTIVE: To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital. METHODS: A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records. RESULTS: We evaluated 466 patients, 58% were men, median age was 40 years, and 146 (31%) of them were diagnosed with sepsis. The overall mortality was 20% being significantly higher for patients with sepsis (39%). The factors associated with intensive care unit mortality were the presence of sepsis (OR: 6.1, 95%CI: 3.7-10.5), age (OR: 3.6, 95%CI: 1.4-7.2), and length of hospital stay (OR: 0.96, 95%CI: 0.94-0.98). Pulmonary (49%) and intra-abdominal (20%) infections were most commonly identified sites, and coagulase-negative staphylococci and enteric Gram negative bacilli the most frequent (66%) pathogens isolated. CONCLUSION: Although the impact of sepsis on mortality is related to patients' clinical and epidemiological characteristics, a critical evaluation of these data is important since they will allow the direct implementation of local policies for managing this serious public health problem.

Assessment of clinical and epidemiological characteristics of patients with and without sepsis in intensive care units of a tertiary hospital / Avaliação das características clínicas e epidemiológicas de pacientes com e sem sepse nas unidades de terapia intensiva de um hospital terciário

ABSTRACT Objective To describe the clinical and epidemiological features of patients with and without sepsis at critical care units of a public hospital. Methods A cross-sectional study was carried out from May 2012 to April 2013. Clinical and laboratory data of patients with and without sepsis in the intensive care units were reviewed of medical records. Results We evaluated 466 patients, 58% were men, median age was 40 years, and 146 (31%) of them were diagnosed with sepsis. The overall mortality was 20% being significantly higher for patients with sepsis (39%). The factors associated with intensive care unit mortality were the presence of sepsis (OR: 6.1, 95%CI: 3.7-10.5), age (OR: 3.6, 95%CI: 1.4-7.2), and length of hospital stay (OR: 0.96, 95%CI: 0.94-0.98). Pulmonary (49%) and intra-abdominal (20%) infections were most commonly identified sites, and coagulase-negative staphylococci and enteric Gram negative bacilli the most frequent (66%) pathogens isolated. Conclusion Although the impact of sepsis on mortality is related to patients' clinical and epidemiological characteristics, a critical evaluation of these data is important since they will allow the direct implementation of local policies for managing this serious public health problem.

RESUMO Objetivo Descrever as características clínicas e epidemiológicas de pacientes com sepse e sem sepse em unidades de cuidados intensivos de um hospital público. Métodos Estudo transversal realizado de maio de 2012 a abril de 2013. Os dados clínicos e laboratoriais de pacientes com sepse e sem sepse das unidades de terapia intensiva foram revisados a partir dos prontuários médicos. Resultados Avaliamos 466 pacientes, 58% homens, mediana de idade 40 anos; sendo 146 (31%) diagnosticados com sepse. A mortalidade global foi 20%, e significativamente maior para pacientes com sepse (39%). Os fatores associados à mortalidade em unidade de terapia intensiva foram a presença de sepse (OR: 6,1, IC95%: 3,7-10,5), idade (OR: 3,6, IC95%: 1,4-7,2) e tempo de internação (OR: 0,96, IC95%: 0,94-0,98). As infecções pulmonares (49%) e intra-abdominais (20%) foram os focos mais comumente identificados, e os estafilococos coagulase-negativa e bacilos entéricos Gram-negativos foram os patógenos isolados mais frequentes (66%). Conclusão Embora o impacto da sepse sobre a mortalidade esteja relacionado às características clínicas e epidemiológicas dos pacientes, uma avaliação crítica desses dados é importante, pois permitirá a implementação direta de políticas locais para gerenciar este grave problema de saúde pública.