Septic death in adults at Surin Hospital: an investigation of real-life clinical practice vs. empirical guidelines.
Article
in English
| IMSEAR
| ID: sea-41722
ABSTRACT
OBJECTIVE:
To explore the cause of death from sepsis and to evaluate the hospital practice in septic patients. MATERIAL ANDMETHOD:
A cross-sectional, retrospective study was conducted between October 2004 and September 2005, at Surin Hospital. The present study included 119 adults (> or = 15 year of age) who were admitted with community-acquired sepsis.RESULTS:
According to the ACCP/SCCM definition, 85.7% of the patients had severe sepsis and up to 71.4% had septic shock. The overall hospital mortality was 73.9% for septic patients and 88.2% for patients in septic shock. The factors that were significantly associated with death from sepsis were age > or = 60 years, presence of co-morbidity, septic shock, organ dysfunctions > or = 3, and acidosis (HCO3 < 20 mEq/L). During hospitalization, 5.9% of patients received ICU care, 29.4% adequate fluid resuscitation, but none had been monitored for Svo2 or Scvo2, and 36.4% had more than a 1-hr delay in the administration of antibiotics. The main cause of death was refractory hypotension (77.3%), in which the amount of fluid therapy during initial resuscitation was significantly associated with the survival of septic shock.CONCLUSION:
Septic shock is the most common cause of death in septic patients. Delayed and inadequate hemodynamic management, including a delay in the administration of antibiotics are the main problems in real-life clinical management of septic patients.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Shock, Septic
/
Thailand
/
Time Factors
/
Female
/
Humans
/
Male
/
Clinical Medicine
/
Cross-Sectional Studies
/
Retrospective Studies
/
Risk Factors
Type of study:
Etiology study
/
Practice guideline
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Observational study
/
Prevalence study
/
Risk factors
Country/Region as subject:
Asia
Language:
English
Year:
2007
Type:
Article
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