title: A prospective observational study assessing the outcome of Sepsis in intensive care unit of a tertiary care hospital, Peshawar.
abstract: OBJECTIVE
  The current study aims to explore the factors associated with outcome among patients with severe sepsis and septic shock admitted to the intensive care unit, Northwest General Hospital and Research Centre, Peshawar, Pakistan.
  
  
  METHODS
  A prospective observational study was carried out at intensive care unit of our hospital from February 2014 to October 2015. Data was collected using a structured format and statistical analysis was done using SPSS version 20®. Regression model was applied to identify the factors contributing to the outcome of severe sepsis and septic shock. P-value less than 0.05 was considered statistically significant.
  
  
  RESULTS
  Majority of the patients meeting the criteria of this study were male 147 (54.9%) with a mean age of 54.8. The most common source of sepsis was lung infections (42.2%) followed by urinary tract infections (18.7%), soft tissue infections (6.3%) abdominal infections (6%) and in 6.3% patients the source remained unknown. Further analysis has revealed that increase in number of days of hospitalization was observed to be slightly associated with the outcome of the treatment (1.086 [1.002 - 1.178], 0.046). Moreover, the risk of mortality was the higher among the patients with septic shock 22.161[10.055 - 48.840], and having respiratory, kidney and central nervous system complications. Overall it is seen that septic shock alone was found responsible to cause death among 32.0% of the patients (Model 1: R(2) 0.32, p=0.000), and upon involvement of the organ complications the risk of mortality was observed to 42.0%.
  
  
  CONCLUSIONS
  Chances of recovery were poor among the patients with septic shock. Moreover, those patients having respiratory and urinary tract infection are least likely to survive.
authors.affiliation: Dr. Arslan Rahat Ullah, FCPS. Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Arslan Rahat
authors.initials: AR
authors.lastname: Ullah
authors.affiliation: Dr. Arshad Hussain, MRCPI. Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Arshad
authors.initials: A
authors.lastname: Hussain
authors.affiliation: Iftikhar Ali, Pharm.D, MPH. Department of Pharmacy, University of Swabi, Khyber Pakhtunkhwa, Pakistan. Department of Pharmacy Services, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Iftikhar
authors.initials: I
authors.lastname: Ali
authors.affiliation: Prof. Abdul Samad, FRCP. Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Abdul
authors.initials: A
authors.lastname: Samad
authors.affiliation: Dr. Syed Tajammul Ali Shah, MBBS. Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Syed Tajammul
authors.initials: ST
authors.lastname: Ali Shah
authors.affiliation: Dr. Muhammad Yousef, MBBS. Department of Medicine & Allied, Northwest General Hospital & Research Centre, Peshawar, Khyber Pakhtunkhwa, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Yousef
authors.affiliation: Dr. Tahir Mehmood Khan, PhD. School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia.
authors.forename: Tahir Mehmood
authors.initials: TM
authors.lastname: Khan
keywords: Infection; Pneumonia; Sepsis; Septic shock; Urosepsis