title: Manatí Medical Center Sepsis Management Epidemiological Study.
abstract: Sepsis is the combination of infection and physiological changes known as the systemic inflammatory response syndrome. There have been improvements in mortality rates and outcomes of septic patients based on "Surviving Sepsis Campaign" guidelines. Current management of sepsis at our Institution follows no specific mandatory protocols. This study aimed to verify the incidence and outcome of sepsis in Manati Medical Center, Puerto Rico. An observational retrospective study was conducted. All the Emergency Department admissions from May 1/ to October 31/ 2013 were screened for sepsis per ICD-9 code. For all included patients, demographic and clinical data at ED admission were collected. During this period 8931 patients were admitted and 148 met criteria for sepsis and related conditions. The overall mortality rate was 43.91%. Mortality increased with age, from 10.52% among ≤ 44 years old to 68.75% in those ≥ 85 years old. The main infection sources were respiratory (32.66%) and urinary tract (24.62%). Mean age among non-survivors was 10.8 years higher than the survivor group (95% Cl 5.2-1 6.5, p < 0.05). Multivariate analysis showed an increased fatality rate associated to severity of sepsis (HR 1.33; 95% Cl; 1.03-1.72, p = 0.02) and the APACHE2 score (HR 1.05; 95% Cl, 1.01-1.09 p = 0.03). Our data suggests that sepsis is an important problem to consider. We strongly encourage an institutional standardized protocol to diminish the mortality impact. Our results will allow adequate preventive strategies to improve early diagnosis, mortality rates and outcomes of septic patients.
authors.forename: Tamara
authors.initials: T
authors.lastname: Morales Serrano
authors.forename: Shirley
authors.initials: S
authors.lastname: Ramos
authors.forename: Yanira
authors.initials: Y
authors.lastname: Lara Gonzalez
authors.forename: Heileene
authors.initials: H
authors.lastname: Torres Colberg
authors.forename: Alexis
authors.initials: A
authors.lastname: Vera Quiñones
authors.forename: Roberto
authors.initials: R
authors.lastname: Miranda Santiago
authors.forename: Samuel
authors.initials: S
authors.lastname: Amill
authors.forename: Marielys
authors.initials: M
authors.lastname: Otero
authors.forename: Vielka
authors.initials: V
authors.lastname: Cintron
authors.forename: Martha Lissete
authors.initials: ML
authors.lastname: Villarreal Morales
mesh_terms: D018806:APACHE; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence; D017052:Hospital Mortality; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology; D064872:Patient Care Bundles; D016016:Proportional Hazards Models; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies; D018805:Sepsis / Q000453:epidemiology / Q000628:therapy*; D012772:Shock, Septic / Q000453:epidemiology / Q000209:etiology; D012959:Socioeconomic Factors; D055815:Young Adult