title: Epidemiology, prognosis, and evolution of management of septic shock in a French intensive care unit: a five years survey.
abstract: Purpose. To evaluate the epidemiology, prognosis, and management of septic shock patients hospitalized in our intensive care unit (ICU). Materiel and Methods. Five-year monocenter observational study including 320 patients. Results. ICU mortality was 54.4%. Independent mortality risk factors were mechanical ventilation (OR = 4.97), Simplify Acute Physiology Score (SAPS) II > 60 (OR = 4.28), chronic alcoholism (OR = 3.38), age >65 years (OR = 2.65), prothrombin ratio <40% (OR = 2.37), and PaO(2)/FiO(2) ratio <150 (OR = 1.91). These six mortality risk factors recovered allow screening immediately septic shock patients with a high mortality risk. Morbidity improved with time (diminution of septic shock complications, increase of the number of days alive free from mechanical ventilation and vasopressors on day 28), concomitant to an evolution of the management (earlier institution of all replacement and medical therapies and more initial volume expansion). There was no difference in mortality. Conclusion. Our study confirms a high mortality rate in septic shock patients despite a new approach of treatment.
authors.affiliation: Intensive Care and Infectious Disease Unit, Tourcoing Hospital, University of Lille, 135, rue du Président Coty, BP 619, 59208 Tourcoing, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Boussekey
authors.forename: Juliette
authors.initials: J
authors.lastname: Cantrel
authors.forename: Lise
authors.initials: L
authors.lastname: Dorchin Debrabant
authors.forename: Joachim
authors.initials: J
authors.lastname: Langlois
authors.forename: Patick
authors.initials: P
authors.lastname: Devos
authors.forename: Agnes
authors.initials: A
authors.lastname: Meybeck
authors.forename: Arnaud
authors.initials: A
authors.lastname: Chiche
authors.forename: Hugues
authors.initials: H
authors.lastname: Georges
authors.forename: Olivier
authors.initials: O
authors.lastname: Leroy