title: Outcomes associated with conventional management of severe sepsis at Damas Hospital.
abstract: Severe sepsis and septic shock have become one of the leading causes of medical intensive care unit (MICU) mortality as well as one of the greater consumers of healthcare resources. Several institutions in the United States have reported positive outcomes after following the Severe Sepsis Campaign (SSC) recommendations. Current management of severe sepsis and septic shock at Damas Hospital's MICU follows no specific protocols or recommendations. This study report data regarding outcomes associated with ongoing management of severe sepsis at our institution.
  
  
  METHODS
  Historical controls with ICD-9 diagnosis of Severe Sepsis and/or Septic Shock hospitalized between January 2007 and August 2009 were randomly selected. Data regarding survival, length of stay (ICU/ In-hospital), and disease severity was gathered through record review. Measured outcomes as well as sociodemographic data were compared to those reported in the literature.
  
  
  RESULTS
  Thirty patients were studied with a mean age of 62 years; 50% male and 50% female. Mean APACHE II score was 21 (40% mortality) with average MICU length of stay of 5.2 days and overall hospital stay of 12.9 days. Overall mortality was 66%.
  
  
  CONCLUSIONS
  There is a high mortality rate associated with conventional management of severely septic patients in Damas Hospital ICU. Studies with similar populations had significantly lower mortality rates based on conventional management of severe sepsis/septic shock. Starting protocoled care of patients with severe sepsis as recommended by the SSC could have a positive impact in the overall mortality at Damas Hospital.
authors: Internal Medicine Residency Program, Damas Hospital, Ponce School of Medicine, Ponce, Puerto Rico. veramarierosado@gmail.com
authors: Vera
authors: V
authors: Rosado
authors: Lisandra
authors: L
authors: Pérez
authors: Héctor
authors: H
authors: Guerra
authors: Ricardo
authors: R
authors: Hernández
authors: Miguel
authors: M
authors: Magraner
authors: Rafael
authors: R
authors: Bredy
mesh_terms: D018806:APACHE; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D017052:Hospital Mortality; D006786:Hospitals, Urban / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies; D012494:Sampling Studies; D018805:Sepsis / Q000401:mortality / Q000628:therapy*; D012772:Shock, Septic / Q000401:mortality / Q000628:therapy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult