title: Incidence and risk factors for sepsis in surgical patients: a cohort study.
abstract: OBJECTIVE
  The aim of the study was to evaluate risk factors for infection and sepsis in surgical patients admitted to the intensive care unit (ICU).
  
  
  METHODS
  Data were prospectively collected from a cohort of surgical patients from January 2005 to December 2007. We analyzed the incidence of infection and sepsis and certain other variables from the pre-, intra-, and postoperative periods as risk factors for infection and sepsis.
  
  
  RESULTS
  We studied 625 surgical patients. The mortality rate was 18.2%, and the mean age of the subjects was 53.1 ± 18.8 years. The incidences of severe sepsis and septic shock were 5% and 11.5%, respectively. A multivariate analysis showed that the following variables were associated with sepsis in the postoperative period: urgent surgery (odds ratio, 2.63; 95% confidence interval [CI], 1.50-4.63), fluid resuscitation (odds ratio, 1.90; 95% CI, 1.18-3.05), vasoactive drugs (odds ratio, 2.58; 95% CI, 1.61-4.14), and mechanical ventilation (odds ratio, 5.51; 95% CI, 3.07-9.89). A Sequential Organ Failure Assessment was associated with infection or sepsis upon ICU admission (area under the curve, 0.737 ± 0.019; 95% CI, 0.748-0.825).
  
  
  CONCLUSIONS
  This study showed that sepsis has high incidence and mortality in surgical patients admitted to the ICU. Urgent surgeries, mechanical ventilation, fluid resuscitation, and vasoactive drugs in the postoperative period and Sequential Organ Failure Assessment at ICU admission were risk factors for sepsis.
authors.affiliation: University Hospital of Londrina, Brazil.
authors.forename: Adriana Cristina Galbiati Parminondi
authors.initials: AC
authors.lastname: Elias
authors.forename: Tiemi
authors.initials: T
authors.lastname: Matsuo
authors.forename: Cintia Magalhães Carvalho
authors.initials: CM
authors.lastname: Grion
authors.forename: Lucienne Tibery Queiroz
authors.initials: LT
authors.lastname: Cardoso
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Verri
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D012772:Shock, Septic / Q000453:epidemiology; D016896:Treatment Outcome