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العنوان
Incidence and Outcome of Sepsis in
Intensive Care Unit
(in Ahmad Maher Teaching Hospital) /
المؤلف
Mohammad, Mohammad Eltohamy.
هيئة الاعداد
باحث / Mohammad Eltohamy Mohammad
مشرف / Gamal Eldin Mohammad Ahmad Elewa
مشرف / Milad Ragaey Zekry
مناقش / Milad Ragaey Zekry
تاريخ النشر
2018.
عدد الصفحات
119
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
العناية المركزة والطب العناية المركزة
تاريخ الإجازة
1/1/2018
مكان الإجازة
جامعة عين شمس - كلية الطب - الرعاية المركزة
الفهرس
Only 14 pages are availabe for public view

from 131

from 131

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