الفهرس | Only 14 pages are availabe for public view |
Abstract Summary Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. To our knowledge, there’s no enough published data about sepsis in intensive cares in Egypt. So, the aim of this study was to investigate incidence, causes and outcome of sepsis in intensive care unit (ICU) of Ahmad Maher Teaching hospital, as a preliminary step to know and compare the incidence, causes and outcome of sepsis in different ICUs in Egypt, aiming to improve our practice. Patients and Methods: This prospective randomized observational study was conducted on forty six adult patients, admitted to ICU of Ahmed Maher Teaching Hospital, Cairo, Egypt, either with sepsis or acquired sepsis in the ICU. Comparison was done between survived and non survived septic patients as regard sepsis-related organ failure assessment (SOFA) score, APACHE II score, and total leucocytic count (TLC) on admission. Also, comparison was done regarding source of infection, number of patients who were on mechanical ventilation, length of ICU stay and number of organs failure. Results: Incidence of sepsis in ICU was 43%. Summary Incidence and Outcome of Sepsis in ICU 85 Medical sepsis cases represented 82.6%, with high mortality rate (73.7%), while surgical sepsis cases were 17.4%, with 26.3% mortality. Patients were admitted with infection category as community acquired (50%) and hospital acquired infections (50%). Comorbidities in the studied patients were mostly diabetes and IHD (56.5% and 37% respectively) followed by chest diseases (13%), renal diseases (10.9%), old cerebro-vascular stroke (CVS) and previous surgery (8.7% each). Sites of infection were mostly respiratory (60.9%) followed by renal (23.9%) then abdominal and (skin and soft tissues) (6.5% each), and least infection was from central venous line (2.2%). The most frequent organisms were gram negative (60.8%), followed by gram positive organisms and fungal infection (19.6% each). Incidence of organs failure was more in nervous system (69.6%) followed by renal (67.4%), circulatory (43.5%), hematological (37%), hepatic (19.6%), and respiratory was the least (13.0%). Twenty two patients (47.8%) suffered from < 3 failed organs, while 24 (52.2%) had ≥ 3 failed organs. Twenty one patients were mechanically ventilated (45.7%). Mechanical ventilation had a statistical significance for mortality; mechanical ventilation was more frequent in non survivors (68.4%) than in survivors (29.6%). Multivariate regression analysis Summary Incidence and Outcome of Sepsis in ICU 86 of different variables showed that predictors for mortality were intra-abdominal infection, TLC on admission, organs failure ≥ 3, and SOFA score. Conclusion: Sepsis constituted the majority of intensive care unit (ICU) patients and carried a significant mortality. APACHE II score, SOFA score, abdominal infection, total leucocytic count on admission, mechanical ventilation, length of ICU stay and organ failure ≥ 3 were significant predictors for mortality |