الفهرس 
SepsisOnly 14 pages are availabe for public view
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Abstract
Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Several studies have provided epidemiological data on sepsis in critically ill patients in the developed countries with increasing incidence and decreasing mortality .However, there is limited information about sepsis in Egypt particularly in respiratory intensive care units (RICUs). This study aimed at assessing the incidence and outcome of sepsis in RICU, providing a crucially important data to increase awareness of the national impact of sepsis and highlighting the need for continued research into potential preventive and therapeutic interventions. This prospective observational study was conducted on patients admitted to RICU of Abbasia Chest Hospital, Cairo, Egypt, either with sepsis or acquired sepsis in the RICU from Severity of illness was assessed by acute physiology and chronic health evaluation (APACHE II score) which was recorded within 24 hours from patient admission. Quick sepsis related organ failure assessment (qSOFA) score was recorded in emergency room and sepsis-related organ failure assessment (SOFA) score was recorded on ICU admission, and on 3rd and 7th day of ICU stay. Incidence of patients with sepsis to total number of patients admitted in the RICU in the same period was calculated. Type of infection (community or hospital acquired), infection site: (lungs, urinary tract, abdomen, surgical wound), pathogenic organisms (gram positive, gram negative, atypical bacteria and fungi) was recorded. Assessment was done also regarding number of patients who were on mechanical ventilation, length of RICU stay, presence of comorbidities, survived patients and dead ones, as regards causes of death and risk factors.
from this study, the following results were obtained:
The total number of patients admitted at RICU during the study period was 403. The total number of patients with sepsis were 100 patients with an incidence rate of sepsis of 24.8 %. Eighty patients were admitted with sepsis (16 of them had septic shock), 20 patients acquired sepsis (12 of them had septic shock) during RICU admission and 15 patients had more than one episode of sepsis. 80% of patients had community acquired infections and 20% had hospital acquired infections. All patients had sepsis due to respiratory infections, in which 40 patients had community acquired pneumonia, 18 patients had ventilator acquired pneumonia, 4 patients had hospital acquired pneumonia, 11 patients had empyema, 17 patients had pulmonary T.B ( new cases ), 6 patients had multiple pyemic lung abscesses, 4 patients had bronchiectasis and 26 patients had acute exacerbation of chronic obstructive pulmonary disease. The total RICU mortality was 220 patients (54.9%). Out of 100 patients with sepsis, 68 patients died (68%) representing 16.8 % of total number of patients admitted to RICU and 30.9% of total mortality at RICU. There was statistically significant increase in age among non survivors when compared with survivors. There was statistically significant mortality among mechanically ventilated patients and a highly statistically significant incidence of complications and need for vasoactive drugs among non survivors when compared with survivors. There were statistically significant impaired kidney functions among non-survivor patients when compared with survivors. There was a highly statistically significant higher APACHE II score on 1st day of admission among non-survivor patients .The SOFA score was significantly higher on 1st day of admission and highly significantly higher on 3rd and 7th day of admission among non-survivors when compared to survivors. In addition, there was highly statistically significant increase in the score in the non-survivors on comparing the score on 1st day of admission with that on the 3rd and 7th day and highly statistically significant reduction of the score in the survivors on comparing the score on 1st day of admission with that on the 7th day ..