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: Gamze Şanlıdağ Işbilen, Deniz Akyol Seyhan, Merve Mert Vahabi, Buse Kenanoğlu, Dilşah Başkol Elik, Seichan Ketentzi, Oğuzhan Acet, Nazlihan Yalçin, Cansu Bulut Avşar, Ayşe Öna, Arda Kaya, Şükrü Dirik, Uğur Öna, Buğra Özkar, Damla Akdağ, Derya Kaya, Gunel Guliyeva, Cansu Tol, Meltem Ceylan, Gökhan Vatansever, Melike Demir, Serhat Uysal, Hilal Sipahi, Şöhret Aydemir, Meltem Taşbakan, Bilgin Arda, Oğuz Reşat Sipahi
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:Journal of Global Antimicrobial Resistance
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213716524003448
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author Gamze Şanlıdağ Işbilen
Deniz Akyol Seyhan
Merve Mert Vahabi
Buse Kenanoğlu
Dilşah Başkol Elik
Seichan Ketentzi
Oğuzhan Acet
Nazlihan Yalçin
Cansu Bulut Avşar
Ayşe Öna
Arda Kaya
Şükrü Dirik
Uğur Öna
Buğra Özkar
Damla Akdağ
Derya Kaya
Gunel Guliyeva
Cansu Tol
Meltem Ceylan
Gökhan Vatansever
Melike Demir
Serhat Uysal
Hilal Sipahi
Şöhret Aydemir
Meltem Taşbakan
Bilgin Arda
Oğuz Reşat Sipahi
author_facet Gamze Şanlıdağ Işbilen
Deniz Akyol Seyhan
Merve Mert Vahabi
Buse Kenanoğlu
Dilşah Başkol Elik
Seichan Ketentzi
Oğuzhan Acet
Nazlihan Yalçin
Cansu Bulut Avşar
Ayşe Öna
Arda Kaya
Şükrü Dirik
Uğur Öna
Buğra Özkar
Damla Akdağ
Derya Kaya
Gunel Guliyeva
Cansu Tol
Meltem Ceylan
Gökhan Vatansever
Melike Demir
Serhat Uysal
Hilal Sipahi
Şöhret Aydemir
Meltem Taşbakan
Bilgin Arda
Oğuz Reşat Sipahi
author_sort Gamze Şanlıdağ Işbilen
collection DOAJ
description 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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spelling doaj-art-b0ebdcfeaccf4e898efb468d5fad83c82024-12-27T04:08:40ZengElsevierJournal of Global Antimicrobial Resistance2213-71652024-12-01395253Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 casesGamze Şanlıdağ Işbilen0Deniz Akyol Seyhan1Merve Mert Vahabi2Buse Kenanoğlu3Dilşah Başkol Elik4Seichan Ketentzi5Oğuzhan Acet6Nazlihan Yalçin7Cansu Bulut Avşar8Ayşe Öna9Arda Kaya10Şükrü Dirik11Uğur Öna12Buğra Özkar13Damla Akdağ14Derya Kaya15Gunel Guliyeva16Cansu Tol17Meltem Ceylan18Gökhan Vatansever19Melike Demir20Serhat Uysal21Hilal Sipahi22Şöhret Aydemir23Meltem Taşbakan24Bilgin Arda25Oğuz Reşat Sipahi26Deparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, TurkeyDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Yüksek İhtisas Research and Teaching Hospital, Bursa, TurkeyDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Uludağ University, Bursa, TurkeyDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Liv Bona Dea Hospital, Baku, AzerbaijanDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Fırat University, Elazıg, TurkeyBornova Directory of Health, Izmir, TurkeyDeparment of Microbiology, Ege University, Izmir, TurkeyDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeDeparment of Infectious Diseases and Clinical Microbiology, Ege University, Izmir, TürkiyeAIM: 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.http://www.sciencedirect.com/science/article/pii/S2213716524003448septic shocksespismortality
spellingShingle Gamze Şanlıdağ Işbilen
Deniz Akyol Seyhan
Merve Mert Vahabi
Buse Kenanoğlu
Dilşah Başkol Elik
Seichan Ketentzi
Oğuzhan Acet
Nazlihan Yalçin
Cansu Bulut Avşar
Ayşe Öna
Arda Kaya
Şükrü Dirik
Uğur Öna
Buğra Özkar
Damla Akdağ
Derya Kaya
Gunel Guliyeva
Cansu Tol
Meltem Ceylan
Gökhan Vatansever
Melike Demir
Serhat Uysal
Hilal Sipahi
Şöhret Aydemir
Meltem Taşbakan
Bilgin Arda
Oğuz Reşat Sipahi
Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
Journal of Global Antimicrobial Resistance
septic shock
sespis
mortality
title Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
title_full Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
title_fullStr Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
title_full_unstemmed Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
title_short Prospective evaluation of septic shock patients in a tertiary care educational university hospital: a series of 1892 cases
title_sort prospective evaluation of septic shock patients in a tertiary care educational university hospital a series of 1892 cases
topic septic shock
sespis
mortality
url http://www.sciencedirect.com/science/article/pii/S2213716524003448
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