Abstract

BERTULLO, Mauricio et al. Epidemiología, diagnóstico y tratamiento de la sepsis severa en Uruguay: un estudio multicéntrico prospectivo. Rev. Méd. Urug. [online]. 2016, vol.32, n.3, pp.178-189. ISSN 0303-3295.

Abstract Objective: to learn about the epidemiological characteristics of patients who are admitted for severe sepsis (SS) and septic shock (Ssh); to assess the implementation of recommendations in the Surviving Sepsis Campaign and to determine variables associated to a bad vital prognosis. Design: prospective, observational study, single cohort, multi-center, conducted in five centers in Montevideo, the public and private sub-sector with coverage for 800,000 inhabitants during one year (September 2011- August 2012). Method: 153 patients who were consecutively admitted with a SS and Ssh diagnosis in the intensive care units. Main relevant variables: those related to characteristics of patients themselves and the sepsis episode, diagnostic and therapeutic measures according to the Surviving Sepsis Campaign in the first 48 hours, and prognostic in the ICU, the hospital and six months later. Results: 153 patients were included, average age was 68 years old and APACHE II 24; 73.9 % of patients needed mechanic ventilation during an average of 8 days. Median length of stay in the ICU was 12 and median hospital stay was 19 days. 69.3% of sepsis were community acquired, 77.8% evidenced shock and 37.9% presented immune deficiency were immunocompromised. Respiratory origin prevailed in 30.2% of patients and in 64.1% of patients the microorganism was identified, bacteria being 95.9% of cases. Mortality in the ICU was 49.7%, in the hospital it was 54.9% and 58.8%. The following were associated to a greater hospital mortality: APACHE II, immune-deficiency, delays in admittance to the ICU and initiation of antimicrobial, and positive balance.

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