title: [An epidemiological study of sepsis in Intensive Care Units: Sepsis Brazil study].
abstract: OBJECTIVE
  Sepsis represents the major cause of death in the ICUs all over the world. Many studies have shown an increasing incidence over time and only a slight reduce in mortality. Many new treatment strategies are arising and we should define the incidence and features of sepsis in Brazil.
  
  
  METHODS
  Prospective cohort study in sixty-five hospitals all over Brazil. The patients who were admitted or who developed sepsis during the month of September, 2003 were enrolled. They were followed until the 28th day and/or until their discharge. The diagnoses were made in accordance to the criteria proposed by ACCP/SCCM. It were evaluated demographic features, APACHE II score, SOFA (Sepsis-related Organ Failure Assessment) score, mortality, sources of infections, microbiology, morbidities and length of stay (LOS).
  
  
  RESULTS
  Seventy-five ICUs from all regions of Brazil took part in the study.3128 patients were identified and 521 (16.7%) filled the criteria of sepsis, severe sepsis or septic shock. Mean age was 61.7 (IQR 39-79), 293 (55.7%) were males, and the overall 28-day mortality rate was 46.6%. Average APACHE II score was 20 and SOFA score on the first day was 7 (IQR 4-10). SOFA score in the mortality group was higher on day 1 (8, IQR 5-11), and had increased on day 3 (9, IQR 6-12). The mortality rate for sepsis, severe sepsis and septic shock was 16.7%, 34.4% and 65.3%, respectively. The average LOS was 15 days (IQR 5-22). The two main sources of infection were the respiratory tract (69%) and the abdomen one (23.1%). Gram-negative bacilli were more prevalent (40.1%). Gram-positive cocci were identified in 32.8% and fungi infections in 5%. Mechanical ventilation was observed in 82.1% of the patients, Swan-Ganz catheter in 18.8%, vasopressors in 66.2% and hemotransfusion in 44.7%.
  
  
  CONCLUSIONS
  It was observed a high mortality of sepsis in the ICUs in Brazil. The high frequency of septic shock demonstrated a group at high risk of death. In order to have a better use of the resources and reduce in mortality during the next 5 years, it is very important to identify our specific features related to this syndrome.
authors.affiliation: Hospital de Clínicas de Niterói.
authors.forename: João Andrade L
authors.initials: JA
authors.lastname: Sales Júnior
authors.affiliation: UTI, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro.
authors.forename: Cid Marcos
authors.initials: CM
authors.lastname: David
authors.affiliation: Hospital São Lucas, Rio de Janeiro.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Hatum
authors.affiliation: UTI, Hospital de Clínicas de Niterói.
authors.forename: Paulo César S P
authors.initials: PC
authors.lastname: Souza
authors.affiliation: UTI, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro.
authors.forename: André
authors.initials: A
authors.lastname: Japiassú
authors.affiliation: UTI, Hospital de Clínicas de Porto Alegre.
authors.forename: Cleovaldo T S
authors.initials: CT
authors.lastname: Pinheiro
authors.affiliation: UTI, Complexo Hospitalar Santa Casa Porto Alegre-Rio Grande do Sul.
authors.forename: Gilberto
authors.initials: G
authors.lastname: Friedman
authors.affiliation: UTI, Hospital Santa Joana, Recife.
authors.forename: Odin Barbosa da
authors.initials: OB
authors.lastname: Silva
authors.affiliation: UTI, Hospital Nove de Julho, São Paulo.
authors.forename: Mariza D Agostino
authors.initials: MD
authors.lastname: Dias
authors.affiliation: H. São Camilo, São Paulo.
authors.forename: Edwin
authors.initials: E
authors.lastname: Koterba
authors.affiliation: UTI, Hospital São Lucas, PUC, Rio Grande do Sul.
authors.forename: Fernando Suparregui
authors.initials: FS
authors.lastname: Dias
authors.affiliation: UTI, Hospital São Lucas, Vitória, ES.
authors.forename: Cláudio
authors.initials: C
authors.lastname: Piras
authors.affiliation: Universidade Federal do Rio de Janeiro.
authors.forename: Ronir Raggio
authors.initials: RR
authors.lastname: Luiz