Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
AIM: We aimed to evaluate the septic shock(SS) cases in terms of mortality and effecting variables for outcomes. BACKGROUND: Despite advancements and the early implementation of targeted therapies,sepsis-related mortality remains high. METHODS: Patients who had SS and consulted to Infectious Disease...
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
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| Series: | Journal of Global Antimicrobial Resistance |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213716524003448 |
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| Summary: | AIM: We aimed to evaluate the septic shock(SS) cases in terms of mortality and effecting variables for outcomes. BACKGROUND: Despite advancements and the early implementation of targeted therapies,sepsis-related mortality remains high. METHODS: Patients who had SS and consulted to Infectious Diseases between December 2013-September 2023 in our center were followed-up prospectively.Arterial lactate level 2 mg/dL criterion was added as an including criteria for SS according to the latest guidelines.Statistical analysis was performed via Chi-square test, a p value<0.05 was considered significant.Neutropenic(<500/mm3) cases were excluded. RESULTS: There were a total of 1892 patients(mean age 66.85±15.18 years and 41.75% female).1057(55.87%) patients in non-hospital acqurieed(admitted with SS or SS developed in less than 48h)(NHASS),835(44.13%) patients in hospital SS(HASS) group fulfilled the study criteria.Mean CRP,leukocyte count,procalcitonin levels were 15.26±11.68 mg/dl,17023±15347/mm3 and 20.77±31.04 µg/l.Arterial lactate level was available in 1534 cases(mean:5.89±4.84 mg/dl). The most common infection sites were pneumonia(n:797-39%) followed by intraabdominal infection(n:428-22.6%) and urinary tract infection(UTI-n:315-16.6%).Microbiological etiology was elucidated in(n:934-49.4%)cases. The most common pathogens were 223 E.coli(%67.8 ESBL+),203 Klebsiella spp.(57.6% carbapenem-resistant),149(7.9%) yeasts and 146 Acinetobacter spp.(91.1% carbapenem-resistant).In 318(34.04%) of 934 cases,>1 pathogen were isolated.One month mortality(OMM) in overall cohort was 76.64% and significantly higher than UTI or intraabdominal infection in the pneumonia SS subgroup(Table,p=0.027).OMM was higher in HASS than in NHASS[79.04%vs.74.64%,p:024].OMM with proven etiology and others were[75.8%vs.77.34%,p:0.427].OMM was significantly higher in lactate>2 subgroup(Table,p<0.001) and in those antibiotics could be started >1 h after the start of the antibiotics(Table,p<0.014). CONCLUSIONS: The worst outcomes were in pneumonia subgroup.We need more efficient diagnostic as well as and therapeutic tools to decrease the significant mortality. |
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| ISSN: | 2213-7165 |