Naslov
Septic Shock in the Medical Intensive Care Unit – Incidence, Management and Outcomes

Autori
Klobučar, Iva ; Vucelić, Vesna ; Degoricija, Vesna

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Book of Abstracts. XIth Mediterranean Emergency Medicine Congress (MEMC) / Moreno, Lisa - St. Julian's : American Academy of Emergency Medicine, 2022, 125-125

Skup
XIth Mediterranean Emergency Medicine Congress (MEMC22)

Mjesto i datum
San Ġiljan, Malta, 21.09.2022. - 24.09.2022

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
septic shock, management, survival

Sažetak
Objective: The aim of the present study was to determine the number, clinical characteristics, methods of management and outcome of the patients with septic shock treated in the Medical Intensive Care Unit (MICU). Background: Septic shock is a subset of sepsis in which profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than sepsis alone (in- hospital mortality>40%).1 Methods: A prospective, observational, clinical study performed in the MICU of the Sisters of Charity University Hospital Centre, Zagreb, Croatia, between April 2017 and May 2018. All patients with sepsis treated in MICU were enrolled in the study. The presence of sepsis and septic shock was determined according to the Sepsis-3 definition.1 Patients' demographic characteristics, clinical data, laboratory test results and MICU outcome were recorded. Results: A total of 116 patients with sepsis were enrolled in the study. Their median age was 73.5 years (range 23-98) and 63 (54.3%) were women. Forty one patient (35.3%) developed septic shock during the MICU treatment. Mortality of the patients with sepsis and septic shock was 63.4%, while the mortality of the sepsis alone was 24.0%. Almost half of deaths caused by the septic shock (46.2%) occurred within the first 24 hours, and 65.4% of deaths within first 72 hours of the MICU treatment [figure1]. Higher age, presence of chronic heart or pulmonary disease, and chronic cerebrovascular disease were more frequently associated with the development of the septic shock in univariate analyses. Multivariate binary logistic regression showed that the independent risk factors for development of septic shock were the permanent immobility [odds ratio (OR) 4.27, 95% confidence interval (CI) 1.82-10.04] and the sepsis originating from biliary tract (OR 6.97, 95% CI 1.16-41.82). Independent risk factors for mortality of the patients with septic shock, using multivariate binary logistic regression, were the inappropriate antimicrobial treatment (OR 161.18, 95% CI 8.24- 3151.26), and the prolonged prothrombin time (OR 0.95, 95% CI 0.91-0.99 ; for PT values expressed as percentages). Conclusions: The death rates of patients with septic shock were high in the present study. Failure in the early choice of the appropriate antibiotic was the most notable mortality risk factor for patients with septic shock, and the only independent risk factor that could be the subject to change.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA