Manatí Medical Center Sepsis Management Epidemiological Study.

Sepsis is the combination of infection and physiological changes known as the systemic inflammatory response syndrome. There have been improvements in mortality rates and outcomes of septic patients based on "Surviving Sepsis Campaign" guidelines. Current management of sepsis at our Institution follows no specific mandatory protocols. This study aimed to verify the incidence and outcome of sepsis in Manati Medical Center, Puerto Rico. An observational retrospective study was conducted. All the Emergency Department admissions from May 1/ to October 31/ 2013 were screened for sepsis per ICD-9 code. For all included patients, demographic and clinical data at ED admission were collected. During this period 8931 patients were admitted and 148 met criteria for sepsis and related conditions. The overall mortality rate was 43.91%. Mortality increased with age, from 10.52% among ≤ 44 years old to 68.75% in those ≥ 85 years old. The main infection sources were respiratory (32.66%) and urinary tract (24.62%). Mean age among non-survivors was 10.8 years higher than the survivor group (95% Cl 5.2-1 6.5, p < 0.05). Multivariate analysis showed an increased fatality rate associated to severity of sepsis (HR 1.33; 95% Cl; 1.03-1.72, p = 0.02) and the APACHE2 score (HR 1.05; 95% Cl, 1.01-1.09 p = 0.03). Our data suggests that sepsis is an important problem to consider. We strongly encourage an institutional standardized protocol to diminish the mortality impact. Our results will allow adequate preventive strategies to improve early diagnosis, mortality rates and outcomes of septic patients.

[Epidemiologic descriptive study of the clinical characteristics of acute bronchiolitis in patients hospitalized at the pediatric unit of the Manatí Medical Center Hospital]. / Estudio descriptivo epidemiológico de las características clínicas de la bronquiolitis aguda en pacientes admitidos a la unidad pediátrica del Hospital Manatí Medical Center.

Acute respiratory infections are the main reason for pediatric visits both to physician's offices and emergency departments. Bronchiolitis is an acute viral respiratory disease that affects about 10% of infants each year and mostly those under age two. The aim of this study was to identify demographic, epidemiological characteristics and risk factors associated with cases of bronchiolitis admitted to the Manati Medical Center (MMC). In addition, we tried to establish the basis for the development of strategies to prevent of hospitalizations and complications in our Institution. A retrospective descriptive study was conducted in the pediatric wing of MMC in Manati, Puerto Rico between January and December 2009. A total of 508 children were included, 58 % of them male. The average age and weight were 12 +/- 5.3 months and 8.1 +/- 1.4 kg, respectively. We observed a higher predisposition among males as well as a statistically significant relationship between breastfeeding and protection from the disease. No relationship was observed between preterm birth and the parents' smoking habit and the development of the disease. However, the latter factor influences the length of hospital stay. The risk of bronchiolitis was seasonal with a peak between October and November. The presence of respiratory syncitial virus was confirmed in 67 % of the cases.