ICU admissions for sepsis: clinical profiles and outcomes in a tertiary care setting, SSG hospital, Vadodara: single-center, descriptive observational study
DOI:
https://doi.org/10.18203/2320-6012.ijrms20242610Keywords:
Critical care, ICU outcomes, Retrospective cohort study, Sepsis, Sofa scoreAbstract
Background: Sepsis is a critical condition leading to high morbidity and mortality rates, especially in intensive care units (ICUs). This study aimed to evaluate the outcomes of patients admitted with sepsis in ICUs across western India, focusing on mortality rates, length of ICU stay, and factors influencing patient outcomes.
Methods: A single-center, descriptive observational study was conducted using medical records from January 2023 to December 2023. The study included 100 patients diagnosed with sepsis upon ICU admission in, SSG hospital Vadodara. Data were collected on demographic characteristics, comorbidities, severity of sepsis (using sofa scores), treatment interventions, ICU length of stay, and mortality outcomes. Statistical analyses were performed to identify predictors of mortality and prolonged ICU stay.
Results: The overall ICU mortality rate among sepsis patients was 32.5%. The median ICU length of stay was 10 days, with a range of 2 to 45 days. Mortality rates were significantly higher in patients with comorbidities such as diabetes (40.2%) and chronic kidney disease (37.8%). The sofa score at admission was a strong predictor of both mortality and prolonged ICU stay. Among the survivors, 65% required mechanical ventilation, and 45% developed acute kidney injury. Early initiation of appropriate antibiotic therapy and source control were associated with improved outcomes.
Conclusions: Sepsis in ICU patients in western India is associated with high mortality and significant resource utilization. Early diagnosis and timely management, particularly in patients with high sofa scores and comorbid conditions, are crucial for improving patient outcomes.
References
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10.
Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intens Care Medic. 2017;43:304-77.
Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-54.
Kissoon N, Carcillo JA, Espinosa V, Argent A, Devictor D, Madden M, et al. World federation of pediatric intensive care and critical care societies: global sepsis initiative. Pediatr Crit Care Med. 2011;12(5):494-503.
Rivers E, Nguyen B, Havstad S, Ressler J, Muzzin A, Knoblich B, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345(19):1368-77.
Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193(3):259-72.
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10.
Rhee C, Dantes R, Epstein L, Murphy DJ, Seymour CW, Iwashyna TJ, et al. Incidence and trends of sepsis in US hospitals using clinical versus claims data, 2009-2014. JAMA. 2017;318(13):1241-9.
Martin GS, Mannino DM, Eaton S, Moss M. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med. 2003;348(16):1546-54.
Fleischmann C, Scherag A, Adhikari NK, Hartog CS, Tsaganos T, Schlattmann P, et al. Assessment of global incidence and mortality of hospital-treated sepsis. Current estimates and limitations. Am J Respir Crit Care Med. 2016;193(3):259-72.
Vincent JL, Moreno R, Takala J, Willatts S, De Mendonça A, Bruining H, et al. The SOFA (Sepsis-related Organ Failure Assessment) score to describe organ dysfunction/failure. Intens Care Med. 1996;22(7):707-10.
Jones AE, Trzeciak S, Kline JA. The sequential organ failure assessment score for predicting outcome in patients with severe sepsis and evidence of hypoperfusion at the time of emergency department presentation. Crit Care Med. 2009;37(5):1649-54.
Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, et al. Developing a new definition and assessing new clinical criteria for septic shock: for the third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):775-87.
Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intens Care Med. 2013;39(2):165-228.
Kumar A, Roberts D, Wood KE, Light B, Parrillo JE, Sharma S, et al. Duration of hypotension before initiation of effective antimicrobial therapy is the critical determinant of survival in human septic shock. Crit Care Med. 2006;34(6):1589-96.
Mukhopadhyay A, Yom SS. Clinical outcomes of sepsis in a general ward of a tertiary care teaching hospital in Mumbai, India. Indian J Crit Care Med. 2013;17(4):197-202.
Kumar A, Ellis P, Arabi Y, Roberts D, Light B, Parrillo JE, et al. Initiation of inappropriate antimicrobial therapy results in a fivefold reduction of survival in human septic shock. Chest. 2009;136(5):1237-48.
Sjoding MW, Prescott HC, Wunsch H, Iwashyna TJ, Cooke CR. Longitudinal changes in ICU admissions among elderly patients in the United States. Crit Care Med. 2016;44(7):1353-60.
