Epidemiology of Sepsis and Septic Shock in the Medical Intensive Care Unit after Implementing the National Early Warning Score for Sepsis Detection
Abstract
Objective: This study aimed to investigate the characteristics, microbiological profile, and mortality of patients with sepsis and septic shock in the medical intensive care unit (MICU).
Material and Methods: Demographic data, clinical characteristics, microbiological profiles, empirical antimicrobial regimen, and hospital mortality were collected retrospectively from patients with sepsis or septic shock that were admitted to the MICU in 2020. The National Early Warning Score (NEWS) of ≥5 was utilized for sepsis screening, and the Sepsis-3 definition was applied to categorize cases of sepsis and septic shock.
Results: Out of the 642 patients admitted to the MICU, 123 patients (19.2%) were included in this study. From these, 70.7% were diagnosed with sepsis and 29.3% with septic shock. The hospital mortality rates of overall patients, sepsis, and septic shock were 28.5%, 20.7%, and 47.2%, respectively. Comorbidities were identified in 89.4%. Septic shock and mortality were associated with higher Sequential Organ Failure Assessment scores, NEWS, and lactate levels (p-value<0.05). The majority of cases were hospital-acquired infections. The respiratory tract was the most affected site of infection. Gram-negative bacteria; particularly Enterobacterales and multidrug-resistant Acinetobacter baumannii, were identified as major pathogens in this study. Carbapenems and vancomycin were primarily prescribed in patients with septic shock, while carbapenems and β-lactam-β-lactamase inhibitors were commonly prescribed for sepsis patients.
Conclusion: Sepsis and septic shock are commonly observed in the MICU, and they are associated with a high mortality rate. The NEWS is a practical tool for sepsis screening in the MICU.
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