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      Time to clearance of abdominal septic focus and mortality in patients with sepsis Translated title: Tempo para evacuação de foco séptico abdominal e mortalidade em portadores de sepse

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          Abstract

          Objective

          To assess the relationship between time to focus clearance and hospital mortality in patients with sepsis and septic shock.

          Methods

          This was an observational, single-center study with a retrospective analysis of the time to clearance of abdominal septic focus. Patients were classified according to the time to focus clearance into an early (≤ 12 hours) or delayed (> 12 hours) group.

          Results

          A total of 135 patients were evaluated. There was no association between time to focus clearance and hospital mortality (≤ 12 hours versus > 12 hours): 52.3% versus 52.9%, with p = 0.137.

          Conclusion

          There was no difference in hospital mortality among patients with sepsis or septic shock who had an infectious focus evacuated before or after 12 hours after the diagnosis of sepsis.

          Translated abstract

          Objetivo

          Aferir a relação entre tempo para evacuação de foco e mortalidade hospitalar em portadores de sepse e choque séptico.

          Métodos

          Estudo observacional, unicêntrico, com análise retrospectiva do tempo para evacuação de foco séptico abdominal. Os pacientes foram classificados conforme o tempo para evacuação do foco em grupo precoce (≤ 12 horas) ou tardio (> 12 horas).

          Resultados

          Foram avaliados 135 pacientes. Não houve associação entre tempo para evacuação do foco e mortalidade hospitalar (≤ 12 horas versus > 12 horas): 52,3% versus 52,9%, com p = 0,137.

          Conclusão

          Não houve diferença na mortalidade hospitalar entre pacientes com sepse ou choque séptico que tiveram foco infeccioso evacuado antes ou após 12 horas do diagnóstico de sepse.

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          Most cited references19

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          The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study

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            Brazilian Sepsis Epidemiological Study (BASES study)

            Introduction Consistent data about the incidence and outcome of sepsis in Latin American intensive care units (ICUs), including Brazil, are lacking. This study was designed to verify the actual incidence density and outcome of sepsis in Brazilian ICUs. We also assessed the association between the Consensus Conference criteria and outcome Methods This is a multicenter observational cohort study performed in five private and public, mixed ICUs from two different regions of Brazil. We prospectively followed 1383 adult patients consecutively admitted to those ICUs from May 2001 to January 2002, until their discharge, 28th day of stay, or death. For all patients we collected the following data at ICU admission: age, gender, hospital and ICU admission diagnosis, APACHE II score, and associated underlying diseases. During the following days, we looked for systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock criteria, as well as recording the sequential organ failure assessment score. Infection was diagnosed according to CDC criteria for nosocomial infection, and for community-acquired infection, clinical, radiological and microbiological parameters were used. Results For the whole cohort, median age was 65.2 years (49–76), median length of stay was 2 days (1–6), and the overall 28-day mortality rate was 21.8%. Considering 1383 patients, the incidence density rates for sepsis, severe sepsis and septic shock were 61.4, 35.6 and 30.0 per 1000 patient-days, respectively. The mortality rate of patients with SIRS, sepsis, severe sepsis and septic shock increased progressively from 24.3% to 34.7%, 47.3% and 52.2%, respectively. For patients with SIRS without infection the mortality rate was 11.3%. The main source of infection was lung/respiratory tract. Conclusion Our preliminary data suggest that sepsis is a major public health problem in Brazilian ICUs, with an incidence density about 57 per 1000 patient-days. Moreover, there was a close association between ACCP/SCCM categories and mortality rate.
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              Management of intra-abdominal infections: recommendations by the WSES 2016 consensus conference

              This paper reports on the consensus conference on the management of intra-abdominal infections (IAIs) which was held on July 23, 2016, in Dublin, Ireland, as a part of the annual World Society of Emergency Surgery (WSES) meeting. This document covers all aspects of the management of IAIs. The Grading of Recommendations Assessment, Development and Evaluation recommendation is used, and this document represents the executive summary of the consensus conference findings.
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                Author and article information

                Journal
                Rev Bras Ter Intensiva
                Rev Bras Ter Intensiva
                rbti
                Revista Brasileira de Terapia Intensiva
                Associação de Medicina Intensiva Brasileira - AMIB
                0103-507X
                1982-4335
                Apr-Jun 2020
                Apr-Jun 2020
                : 32
                : 2
                : 245-250
                Affiliations
                [1 ] Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
                [2 ] Programa Intrahospitalar de Combate à Sepse, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
                [3 ] Programa de Pós-Graduação em Ciências Pneumológicas, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
                [4 ] Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brasil.
                Author notes
                Corresponding author: Rafael Barberena Moraes, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2.350 - Santa Cecília, Zip code: 90035-007 - Porto Alegre (RS), Brazil. E-mail: moraesrb@ 123456hotmail.com
                Author information
                http://orcid.org/0000-0001-6631-7260
                Article
                10.5935/0103-507X.20200029
                7405735
                32667437
                7d0aa112-48e3-4c59-acee-d32fdb44fcd4

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 04 April 2019
                : 26 December 2019
                Categories
                Original Article

                sepsis,septic shock,hospital mortality,intraabdominal infections/complications,infections,sepse,choque séptico,mortalidade hospitalar,infecções intra-abdominais/complicações,infecções

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