scholarly journals Clinical outcome and predictors of mortality in children with sepsis, severe sepsis, and septic shock from Rohtak, Haryana: A prospective observational study

2014 ◽  
Vol 18 (7) ◽  
pp. 437-441 ◽  
Author(s):  
Gurpreet Kaur ◽  
Jaya Shankar Kaushik ◽  
Nikhil Vinayak ◽  
Mohammad Aamir
2008 ◽  
Vol 34 (7) ◽  
pp. 1294-1298 ◽  
Author(s):  
E. Christiaan Boerma ◽  
Michael A. Kuiper ◽  
W. Peter Kingma ◽  
Peter H. Egbers ◽  
Rik T. Gerritsen ◽  
...  

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Toshikazu Abe ◽  
◽  
Shigeki Kushimoto ◽  
Yasuharu Tokuda ◽  
Gary S. Phillips ◽  
...  

Abstract Background Time to antibiotic administration is a key element in sepsis care; however, it is difficult to implement sepsis care bundles. Additionally, sepsis is different from other emergent conditions including acute coronary syndrome, stroke, or trauma. We aimed to describe the association between time to antibiotic administration and outcomes in patients with severe sepsis and septic shock in Japan. Methods This prospective observational study enrolled 1184 adult patients diagnosed with severe sepsis based on the Sepsis-2 criteria and admitted to 59 intensive care units (ICUs) in Japan between January 1, 2016, and March 31, 2017, as the sepsis cohort of the Focused Outcomes Research in Emergency Care in Acute Respiratory Distress Syndrome, Sepsis and Trauma (FORECAST) study. We compared the characteristics and in-hospital mortality of patients administered with antibiotics at varying durations after sepsis recognition, i.e., 0–60, 61–120, 121–180, 181–240, 241–360, and 361–1440 min, and estimated the impact of antibiotic timing on risk-adjusted in-hospital mortality using the generalized estimating equation model (GEE) with an exchangeable, within-group correlation matrix, with “hospital” as the grouping variable. Results Data from 1124 patients in 54 hospitals were used for analyses. Of these, 30.5% and 73.9% received antibiotics within 1 h and 3 h, respectively. Overall, the median time to antibiotic administration was 102 min [interquartile range (IQR), 55–189]. Compared with patients diagnosed in the emergency department [90 min (IQR, 48–164 min)], time to antibiotic administration was shortest in patients diagnosed in ICUs [60 min (39–180 min)] and longest in patients transferred from wards [120 min (62–226)]. Overall crude mortality was 23.4%, where patients in the 0–60 min group had the highest mortality (28.0%) and a risk-adjusted mortality rate [28.7% (95% CI 23.3–34.1%)], whereas those in the 61–120 min group had the lowest mortality (20.2%) and risk-adjusted mortality rates [21.6% (95% CI 16.5–26.6%)]. Differences in mortality were noted only between the 0–60 min and 61–120 min groups. Conclusions We could not find any association between earlier antibiotic administration and reduction in in-hospital mortality in patients with severe sepsis.


Author(s):  
Quang Hiển Nguyễn Viết

RESEARCH THE VALUE OF PRESEPSIN IN SEPTIC SHOCK PATIENTS Objective: To investigate the prognostic severity and mortality value of presepsin in patients with severe sepsis and septic shock. Subject and Methods: Eighty patients with severe sepsis and septic shock according to ACCP/SCCM (2001) were included. A prospective, observational study. Blood samples were collected at first medical evaluation to measure presepsin level. Result: The serum presepsin level was positively correlated with SOFA score (r = 0.39, p <0.001), APACHE II score (r = 0.33, p <0.01 ) and number of organ dysfunction (r = 0.36, p <0.05). Area under the curve (AUC) of presepsin in prognostic mortality is 0.77, showed significant (p<0.001), at cut-off value 488,1 pg/ml, sensitivity 83.7% and specificity 100%. Conclusion: Serum presepsin levels correlated with the severity of sepsis and has mortality prediction value in severe sepsis and septic patients Key words: presepsin, severe sepsis, septic shock.


2021 ◽  
Author(s):  
Sukyo Lee ◽  
Juhyun Song ◽  
Dae Won Park ◽  
Hyeri Seok ◽  
Jae-hyung Cha ◽  
...  

Abstract Background: Sepsis is life-threatening organ dysfunction due to a dysregulated host response to infection. Early diagnosis of sepsis is challenging due to unknown sources of infection, and mortality prediction is usually complex. We aimed to investigate the clinical value of presepsin for discriminating sepsis from non-infectious organ failure and predicting mortality among sepsis patients in the emergency department (ED).Methods: This prospective observational study included 420 patients divided into three groups according to the Sepsis-3 definitions: non-infectious organ failure (n=142), sepsis (n=141), and septic shock (n=137). Blood samples for biomarker measurement of presepsin, procalcitonin, and C-reactive protein were drawn in the ED and biomarker levels were compared between the groups. Optimal cut-off values for presepsin to discriminate between the three clinical diagnoses were evaluated using receiver operating characteristic (ROC) curve analysis. We also performed ROC curve analysis for each biomarker as a predictor of mortality. After excluding non-infectious organ failure, we extracted the optimal cut-off value of presepsin to predict mortality associated with sepsis and septic shock and performed Kaplan–Meier survival curve analysis according to the cut-off value.Results: Presepsin levels (median [IQR]) were significantly higher in sepsis than in non-infectious organ failure (792 [450–1273] vs. 286 [170–417], p <0.001) and significantly higher in septic shock than in sepsis (1287 [589–2365] vs. 792 [450–1273], p=0.002). The optimal cut-off value for presepsin to discriminate between sepsis and non-infectious organ failure was 582 pg/mL (sensitivity, 70.1; specificity, 89.4; AUC, 0.877; p <0.001) and to discriminate between sepsis and septic shock was 1285 pg/mL (sensitivity, 50.4; specificity, 76.6; AUC, 0.618; p <0.001). The optimal cut-off value for presepsin for predicting 30-day mortality was 821 pg/mL (sensitivity, 68.9; specificity, 50.5; AUC, 0.605; p=0.005) in patients with sepsis and septic shock. Kaplan-Meier survival curve analysis showed that patients with higher presepsin levels (≥821 pg/mL) had significantly higher mortality than patients with lower presepsin levels (<821 pg/mL) (log-rank test; p=0.004). Conclusions: Presepsin levels could effectively differentiate sepsis from non-infectious organ failure and septic shock from sepsis. Presepsin levels could help clinicians predict mortality in patients with sepsis and septic shock.


Critical Care ◽  
2013 ◽  
Vol 17 (Suppl 4) ◽  
pp. P36 ◽  
Author(s):  
Mônica de Carvalho ◽  
José Pestana ◽  
Flávio Freitas ◽  
Flávia Machado ◽  
Hélio Júnior

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