Clinical profile and outcome of organ dysfunction in sepsis

Laxmikanta Dash, Lagendra Kumar Singh, Malati Murmu, Susruth Krishnadas P., Amita Kerketta, Mrutyunjay B. Hiregoudar


Background: Sepsis is defined as life threatening organ dysfunction due to a dysregulated host response to infection. It is the tenth leading cause of death among older adults in United States. Mortality rate of the sepsis ranges from 30-40%. In severe cases sepsis can drastically reduce blood flow to the major organs, leading eventually to septic shock, widespread organ failure and death. So, the present study was done to evaluate the clinical profile, symptoms, source of infection, co-morbid conditions and outcome with respect to the organ dysfunction in sepsis cases.

Methods: This prospective observational study was undertaken among 100 cases of sepsis diagnosed by the “International Sepsis Definitions Conference” criteria admitted during October 2015 to September 2017. All patients were evaluated clinically and subjected for laboratory investigations.

Results: In present study, a total of 100 cases were enrolled. Mean age of cases were 38.15 years. Male and female ratio was 1.63:1. Most common symptom was fever (100%). Pneumonia was the most common (36%) source of infection. Mortality was highest in pneumonia (55.55%). 77 % of cases had organ dysfunction. Cardiovascular system was the most common system involved. Maximum mortality was within the age group of 56-65 years. Diabetes was the most common co-morbid condition. Mean APACHE II score was high among the death cases.

Conclusions: Sepsis was more common in younger group of patients but mortality was more in elderly age group. Overall mortality was 38%.



APACHE II, MODS, Outcome, Sepsis, Vasopressors

Full Text:



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.

Eliezer S. Marcelo de Almeida Pedro Critical Brazilian Sepsis Epidemiological Study (BASES Study). Care. 2004;8:251-60.

Cabre L, Mancebo J, Solsona JF, Saura P, Gich I, Blanch L, et al. Bioethics Working Group of the SEMICYUC Multicenter study of the multiple organ dysfunction syndrome in intensive care units: the usefulness of Sequential Organ Failure Assessment scores in decision making. Intensive Care Med. 2005;31(7):927-33.

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. Crit Care Med. 2013;4:580-637.

Sharma S. Multiple organ failure of sepsis. Infectious Diseases. 2003;9:199-209.

Vincent JL, Nelson DR, Williams MD. Is worsening multiple organ failure the cause of death in patients with severe sepsis? Crit Care Med. 2011;39(5):1050-5.

Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Critical care medicine. 2001 Jul 1;29(7):1303-10.

Simon F. Rinaldo B, Jeffrey L. Adult population incidence of severe sepsis in Australian and New Zealand intensive care units. Intensive Care Med. 2004;30:589-96.

Brun-Buisson C. Meshaka P, Pinton P, Vallet B. EPISEPSIS: a reappraisal of the epidemiology and outcome of severe sepsis in French intensive units. Intensive Care Med. 2004;30:580-8.

Jawad I, Luksic I, Raffnson SB. Assessing available information on the burden of sepsis: global estimates of incidence, prevalence and mortality. J Global Health. 2012;2:1040-44.

Tanriover MD, Guven GS, Sen D, Unal S, Uzun O. Epidemiology and outcome of sepsis in a tertiary care hospital in a developing country. Epidemiology and Infection. 2006;134:315-22.

Todi S, Chatterjee S, Sahu S, Bhattacharya M. Epidemiology of severe sepsis in India: an update. Crit Care. 2010;14(1):382.

Guidet B, Aegerter P, Gauzit R, Meshaka P, Dreyfuss D. CUB-Rea Study Group: Incidence and impact of Organ Dysfunctions Associated with Sepsis. Chest. 2005;127(3):942-51.

Levy MM, Fink MP, Marshall JC, Abraham E, Angus D, Cook D, et al. 2001 sccm/esicm/accp/ats/sis international sepsis definitions conference. Intensive care medicine. 2003 Apr 1;29(4):530-8.

Knaus WA, Draper EA, Wagner DP, Zimmerman JE. APACHE II: a severity of disease classification system.Crit Care Med. 1985 Oct;13(10):818-29.

Bhattacharya PK, Gautom D, Nath N, Saikia H. A comparative Study to Assess the Determinants and outcomes of Sepsis Treated in Medical Wards and ICU in an Indian Teaching Hospital. J Clin Diagn Res. 2016 Jun;10(6):OC01-6.

Gaieski DF, Edwards JM, Kallan MJ, Carr BG. Benchmarking the incidence and mortality of severe sepsis in the United States. Crit Care Med. 2013;41(5):1167-74.

Paary TTS, Kalaiselvan MS, Renuka MK, Arunkumar AS. Clinical profile and outcome of patients with severe sepsis treated in an intensive care unit in India. Ceylon Med J. 2016;61(4):181-4.

Todi S, Chatterjee S, Sahu S, Bhattacharya M. Epidemiology of severe sepsis in India: an update. Crit Care. 2010;14(1):382.

Engel C, Brunkhorst FM, Bone HG, Brunkhorst R, Gerlach H, Grond S, et al. Epidemiology of sepsis in Germany: results from a national prospective multicenter study. Intensive Care Med. 2007 Apr 1;33(4):606-18.

Karlsson S, Varpula M, Ruokonen E, Pettilä V, Parviainen I, Ala-Kokko TI, et al. Incidence, treatment, and outcome of severe sepsis in ICU-treated adults in Finland: the Finnsepsis study. Intensive care medicine. 2007 Mar 1;33(3):435-43.

Desai SR, Lakhani JD. Clinical Profile of Patients with Multi-organ Dysfunction in Patients of Sepsis in Rural set up MICU. PJSR. 2014;7(2):28-32.

Fedeli U, Piccinni P, Schievano E, Saugo M, Pellizzer G. Growing burden of sepsis-related mortality in northeastern Italy: a multiple causes of death analysis. BMC infectious diseases. 2016 Dec;16(1):330.

Leligdowicz A, Dodek PM, Norena M, Wong H, Kumar A, Kumar A. Co-operative Antimicrobial Therapy of Septic Shock Database Research Group. Association between source of infection and hospital mortality in patients who have septic shock. American journal of respiratory and critical care medicine. 2014 May 15;189(10):1204-13.

Umegaki T, Ikai H, Imanaka Y. The impact of acute organ dysfunction on patients’ mortality with severe sepsis. J Anaesthesiol Clin Pharmacol. 2011 April-Jun;27(2):180-4.

Artero A, Zaragoza R, Camarena JJ, Sancho S, González R, Nogueira JM. Prognostic factors of mortality in patients with community-acquired bloodstream infection with severe sepsis and septic shock. J of Crit Care. 2010 Jun 1;25(2):276-81.

Martin GS, Mannino DM, Moss M. Effect of age on the development and outcome with sepsis. Am J Respir Crit Care Med. 2003;167:837.