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Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia / Elisa Bernal Sierra    

Público ISBD Título : Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia Otros títulos : Asociación entre el sitio de infección y la mortalidad hospitalaria en pacientes con sepsis atendidos en urgencias de hospitales de tercer nivel en Medellín, Colombia Tipo de documento : documento electrónico Autores : Elisa Bernal Sierra, Fecha de publicación : 2019 Títulos uniformes : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Sepsis  septic shock  shock  mortality  prognosis  infection  intensive care Resumen : Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality.Results: The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p Mención de responsabilidad : César Caraballo, Johana Ascuntar, Carolina Hincapié, Camilo Restrepo, Elisa Bernal, Fabián Jaimes Referencia : Rev Bras Ter Intensiva. 2019 Jan-Mar;31(1):47-56 DOI (Digital Object Identifier) : 10.5935/0103-507X.20190011 PMID : 30970091 Derechos de uso : CC BY En línea : http://www.rbti.org.br/artigo/detalhes/0103507X-31-1-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4254 Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia = Asociación entre el sitio de infección y la mortalidad hospitalaria en pacientes con sepsis atendidos en urgencias de hospitales de tercer nivel en Medellín, Colombia [documento electrónico] / Elisa Bernal Sierra,  . - 2019. Obra : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Sepsis  septic shock  shock  mortality  prognosis  infection  intensive care Resumen : Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality.Results: The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p Mención de responsabilidad : César Caraballo, Johana Ascuntar, Carolina Hincapié, Camilo Restrepo, Elisa Bernal, Fabián Jaimes Referencia : Rev Bras Ter Intensiva. 2019 Jan-Mar;31(1):47-56 DOI (Digital Object Identifier) : 10.5935/0103-507X.20190011 PMID : 30970091 Derechos de uso : CC BY En línea : http://www.rbti.org.br/artigo/detalhes/0103507X-31-1-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4254

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Epidemiology of sepsis in Colombian intensive care units / Gisela de la Rosa Echavez  

Público ISBD Título : Epidemiology of sepsis in Colombian intensive care units Otros títulos : Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia Tipo de documento : documento electrónico Autores : Gisela de la Rosa Echavez, Fecha de publicación : 2014 Títulos uniformes : Biomédica Idioma : Inglés (eng) Palabras clave : Sepsis/epidemiology  septic shock  intensive care Resumen : Introduction: Currently, there is not enough data available concerning sepsis in developing countries, especially in Latin America. Objective: We developed a study aimed at determining the frequency, clinical and epidemiological characteristics, and the consequences of sepsis in patients requiring admission to intensive care units in Colombia. Materials and methods: This was a secondary analysis of a prospective cohort study carried out over a six-month period, from September 1, 2007, to February 28, 2008, in ten medical/surgical intensive care units in four Colombian cities. Patients were considered eligible if they had a probable or confirmed diagnosis of infection according to medical records. We recorded demographic characteristics, first admission diagnosis and co-morbidities, clinical status, and sepsis, severe sepsis or septic shock. Results: During the study period, 826 patients were admitted to the intensive care units. From these patients, 421 (51%) developed sepsis in the community, 361 (44%) in the ICU, and 44 (5%) during hospitalization in the general ward. Two hundred and fifty three patients (30.6%) had involvement of one organ system: 20% had respiratory involvement, followed by kidney and central nervous system involvement with 3.4% and 2.7%, respectively. Conclusions: In our cohort of septic patients, the prevalence of sepsis treated in ICU is similar to that reported in other studies, as well as the overall mortality. Mención de responsabilidad : Guillermo Ortíz, Carmelo Dueñas, Ferney Rodríguez, Lena Barrera, Gisela de La Rosa, Rodolfo Dennis, Marcela Granados, Darío Londoño, Francisco Molina, Fabián Jaimes Referencia : Biomedica. 2014 Jan-Mar;34(1):40-7. DOI (Digital Object Identifier) : 10.7705/biomedica.v34i1.1439 PMID : 24967858 En línea : https://www.revistabiomedica.org/index.php/biomedica/article/view/1439 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3806 Epidemiology of sepsis in Colombian intensive care units = Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia [documento electrónico] / Gisela de la Rosa Echavez,  . - 2014. Obra : Biomédica Idioma : Inglés (eng) Palabras clave : Sepsis/epidemiology  septic shock  intensive care Resumen : Introduction: Currently, there is not enough data available concerning sepsis in developing countries, especially in Latin America. Objective: We developed a study aimed at determining the frequency, clinical and epidemiological characteristics, and the consequences of sepsis in patients requiring admission to intensive care units in Colombia. Materials and methods: This was a secondary analysis of a prospective cohort study carried out over a six-month period, from September 1, 2007, to February 28, 2008, in ten medical/surgical intensive care units in four Colombian cities. Patients were considered eligible if they had a probable or confirmed diagnosis of infection according to medical records. We recorded demographic characteristics, first admission diagnosis and co-morbidities, clinical status, and sepsis, severe sepsis or septic shock. Results: During the study period, 826 patients were admitted to the intensive care units. From these patients, 421 (51%) developed sepsis in the community, 361 (44%) in the ICU, and 44 (5%) during hospitalization in the general ward. Two hundred and fifty three patients (30.6%) had involvement of one organ system: 20% had respiratory involvement, followed by kidney and central nervous system involvement with 3.4% and 2.7%, respectively. Conclusions: In our cohort of septic patients, the prevalence of sepsis treated in ICU is similar to that reported in other studies, as well as the overall mortality. Mención de responsabilidad : Guillermo Ortíz, Carmelo Dueñas, Ferney Rodríguez, Lena Barrera, Gisela de La Rosa, Rodolfo Dennis, Marcela Granados, Darío Londoño, Francisco Molina, Fabián Jaimes Referencia : Biomedica. 2014 Jan-Mar;34(1):40-7. DOI (Digital Object Identifier) : 10.7705/biomedica.v34i1.1439 PMID : 24967858 En línea : https://www.revistabiomedica.org/index.php/biomedica/article/view/1439 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3806

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Clinical course of sepsis, severe sepsis, and septic shock in a cohort of infected patients from ten Colombian hospitals / Fabián Alberto Jaimes Barragán ; Gisela de la Rosa Echavez    

Público ISBD Título : Clinical course of sepsis, severe sepsis, and septic shock in a cohort of infected patients from ten Colombian hospitals Tipo de documento : documento electrónico Autores : Fabián Alberto Jaimes Barragán, ; Gisela de la Rosa Echavez, Fecha de publicación : 2013 Títulos uniformes : BMC Infectious Diseases Idioma : Inglés (eng) Palabras clave : Severe sepsis  septic shock  progression  GEE  cox regression Resumen : Background: Sepsis has several clinical stages, and mortality rates are different for each stage. Our goal was to establish the evolution and the determinants of the progression of clinical stages, from infection to septic shock, over the first week, as well as their relationship to 7-day and 28-day mortality. Methods: This is a secondary analysis of a multicenter cohort of inpatients hospitalized in general wards or intensive care units (ICUs). The general estimating equations (GEE) model was used to estimate the risk of progression and the determinants of stages of infection over the first week. Cox regression with time-dependent covariates and fixed covariates was used to determine the factors related with 7-day and 28-day mortality, respectively. Results: In 2681 patients we show that progression to severe sepsis and septic shock increases with intraabdominal and respiratory sources of infection [OR = 1,32; 95%IC = 1,20-1,46 and OR = 1.21, 95%CI = 1,11-1,33 respectively], as well as according to Acute Physiology and Chronic Health Evaluation II (APACHE II) [OR = 1,03; 95%CI = 1,02-1,03]and Sequential Organ Failure Assessment (SOFA) [OR = 1,16; 95%CI = 1,14-1,17] scores. The variables related with first-week mortality were progression to severe sepsis [HR = 2,13; 95%CI = 1,13-4,03] and septic shock [HR = 3,00; 95%CI = 1,50-5.98], respiratory source of infection [HR = 1,76; 95%IC = 1,12-2,77], APACHE II [HR = 1,07; 95% CI = 1,04-1,10] and SOFA [HR = 1,09; 95%IC = 1,04-1,15] scores. Conclusions: Intraabdominal and respiratory sources of infection, independently of SOFA and APACHE II scores, increase the risk of clinical progression to more severe stages of sepsis; and these factors, together with progression of the infection itself, are the main determinants of 7-day and 28-day mortality. Mención de responsabilidad : Alba Luz León, Natalia Andrea Hoyos, Lena Isabel Barrera, Gisela De La Rosa, Rodolfo Dennis, Carmelo Dueñas, Marcela Granados, Dario Londoño, Ferney Alexander Rodríguez, Francisco José Molina, Guillermo Ortiz, Fabián Alberto Jaimes Referencia : BMC Infect Dis. 2013 Jul 24;13:345. DOI (Digital Object Identifier) : 10.1186/1471-2334-13-345 PMID : 23883312 Derechos de uso : CC BY En línea : https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-345 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3690 Clinical course of sepsis, severe sepsis, and septic shock in a cohort of infected patients from ten Colombian hospitals [documento electrónico] / Fabián Alberto Jaimes Barragán, ; Gisela de la Rosa Echavez,  . - 2013. Obra : BMC Infectious Diseases Idioma : Inglés (eng) Palabras clave : Severe sepsis  septic shock  progression  GEE  cox regression Resumen : Background: Sepsis has several clinical stages, and mortality rates are different for each stage. Our goal was to establish the evolution and the determinants of the progression of clinical stages, from infection to septic shock, over the first week, as well as their relationship to 7-day and 28-day mortality. Methods: This is a secondary analysis of a multicenter cohort of inpatients hospitalized in general wards or intensive care units (ICUs). The general estimating equations (GEE) model was used to estimate the risk of progression and the determinants of stages of infection over the first week. Cox regression with time-dependent covariates and fixed covariates was used to determine the factors related with 7-day and 28-day mortality, respectively. Results: In 2681 patients we show that progression to severe sepsis and septic shock increases with intraabdominal and respiratory sources of infection [OR = 1,32; 95%IC = 1,20-1,46 and OR = 1.21, 95%CI = 1,11-1,33 respectively], as well as according to Acute Physiology and Chronic Health Evaluation II (APACHE II) [OR = 1,03; 95%CI = 1,02-1,03]and Sequential Organ Failure Assessment (SOFA) [OR = 1,16; 95%CI = 1,14-1,17] scores. The variables related with first-week mortality were progression to severe sepsis [HR = 2,13; 95%CI = 1,13-4,03] and septic shock [HR = 3,00; 95%CI = 1,50-5.98], respiratory source of infection [HR = 1,76; 95%IC = 1,12-2,77], APACHE II [HR = 1,07; 95% CI = 1,04-1,10] and SOFA [HR = 1,09; 95%IC = 1,04-1,15] scores. Conclusions: Intraabdominal and respiratory sources of infection, independently of SOFA and APACHE II scores, increase the risk of clinical progression to more severe stages of sepsis; and these factors, together with progression of the infection itself, are the main determinants of 7-day and 28-day mortality. Mención de responsabilidad : Alba Luz León, Natalia Andrea Hoyos, Lena Isabel Barrera, Gisela De La Rosa, Rodolfo Dennis, Carmelo Dueñas, Marcela Granados, Dario Londoño, Ferney Alexander Rodríguez, Francisco José Molina, Guillermo Ortiz, Fabián Alberto Jaimes Referencia : BMC Infect Dis. 2013 Jul 24;13:345. DOI (Digital Object Identifier) : 10.1186/1471-2334-13-345 PMID : 23883312 Derechos de uso : CC BY En línea : https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-13-345 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3690

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