title: Survey on physicians' knowledge of sepsis: do they recognize it promptly?
abstract: OBJECTIVE
  In Brazil, sepsis has a high mortality; and early recognition is essential in outcome. The aim of the study was to evaluate physicians' knowledge about systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock concepts.
  
  
  METHODS
  This was a prospective, observational study performed in 21 hospitals in Brazil, which enrolled physicians working in the participant institutions. A previously validated questionnaire was applied to physicians including 5 clinical cases.
  
  
  RESULTS
  Twenty-one Brazilian institutions enrolled 917 physicians. The percentage of physicians correctly recognizing SIRS, infection, sepsis, severe sepsis, and septic shock was 78.2%, 92.6%, 27.3%, 56.7%, and 81.0%, respectively. Intensivists performed better in all diagnoses. There was a significantly higher rate of correct answers for SIRS (P < .001), sepsis (P = .001), and severe sepsis (P = .032) among physicians from university hospitals as compared with those from public hospitals. A mean global score of 3.36 ± 1.08 was found, with better performance for residents (P = .012) and intensivists (P < .001); but no difference was found for emergency physicians (P = .875).
  
  
  CONCLUSIONS
  The prompt recognition of sepsis and its severity is not satisfactory. This difference is probably due to the difficulty in the recognition of organ dysfunction, which hampers early identification of septic patients.
authors.affiliation: Disciplina de Anestesiologia, Dor e Terapia Intensiva. Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil. murilloassuncao@gmail.com
authors.forename: Murillo
authors.initials: M
authors.lastname: Assunção
authors.forename: Nelson
authors.initials: N
authors.lastname: Akamine
authors.forename: Guttemberg S
authors.initials: GS
authors.lastname: Cardoso
authors.forename: Patricia V C
authors.initials: PV
authors.lastname: Mello
authors.forename: José Mário M
authors.initials: JM
authors.lastname: Teles
authors.forename: André Luis B
authors.initials: AL
authors.lastname: Nunes
authors.forename: Marcelo Oliveira
authors.initials: MO
authors.lastname: Maia
authors.forename: Alvaro
authors.initials: A
authors.lastname: Rea-Neto
authors.forename: Flavia Ribeiro
authors.initials: FR
authors.lastname: Machado
mesh_terms: D000328:Adult; D001938:Brazil; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003422:Critical Care; D005260:Female; D016304:Hospitals, Private; D006779:Hospitals, Public; D006785:Hospitals, University; D006801:Humans; D007239:Infections / Q000175:diagnosis; D008297:Male; D008505:Medical Staff, Hospital; D011446:Prospective Studies; D018805:Sepsis / Q000175:diagnosis*; D012772:Shock, Septic / Q000175:diagnosis; D011795:Surveys and Questionnaires; D018746:Systemic Inflammatory Response Syndrome / Q000175:diagnosis