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Vol. 152. Issue 1.
Pages 13-16 (January 2019)
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Vol. 152. Issue 1.
Pages 13-16 (January 2019)
Brief report
Application of the new Sepsis-3 definition in a cohort of patients with severe sepsis and septic shock admitted to Intensive Care Unit from the Emergency Department
Aplicación de la nueva definición Sepsis-3 en una cohorte de pacientes con sepsis grave y shock séptico ingresados en unidad de cuidados intensivos desde el Servicio de Urgencias
Renata García-Gigorro
Corresponding author
rennygg@hotmail.com

Corresponding author.
, Zaira Molina-Collado, Ignacio Sáez-de la Fuente, José Ángel Sanchez-Izquierdo, Juan Carlos Montejo González
Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain
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Table 1. Characteristics of the patients with a severe infection according to the definition used.
Abstract
Background and objectives

After the publication of the new definition for sepsis and septic shock, our objective is to analyze the evolution of patients admitted to ICU with an infection process using the previous and new recommendations.

Materials and methods

This is a sub-analysis of a previous observational prospective study. We included 98 patients admitted to ICU from the emergency department due to infection during an 18-month period. We studied the clinical evolution during ICU admission and hospital mortality.

Results

According to Sepsis-2 definition, 78% percent had septic shock and using Sepsis-3 criteria, 52%; hospital mortality was 29 and 41%, respectively. The RR of hospital mortality of septic shock was 10.3 (95% CI: 2.8–37.5) compared to patients without shock. The 30-day probability survival of patients with sepsis and septic shock were 78% and 68%, respectively (long rank<0.001).

Conclusions

In our experience, the incorporation of the SOFA score and lactate levels to the new definition could help improve the evaluation of risk of hospital death.

Keywords:
Sepsis
Septic shock
Lactate
Hospital mortality
Resumen
Antecedentes y objetivo

Tras la publicación de la nueva definición de sepsis y shock séptico, nuestro objetivo es analizar la evolución de los pacientes que ingresan en UCI por enfermedad infecciosa utilizando la definición clásica y los nuevos criterios.

Material y métodos

Subanálisis de un estudio observacional y prospectivo. Incluye a 98 pacientes ingresados en UCI por enfermedad infecciosa desde Urgencias durante 18 meses. Se estudió la evolución clínica en UCI y la mortalidad hospitalaria.

Resultados

El 78% de los pacientes tuvieron shock séptico con la definición Sepsis-2 y el 52% con los criterios Sepsis-3. La mortalidad hospitalaria fue del 29 y del 41%, respectivamente. El RR de mortalidad hospitalaria de los pacientes con shock séptico fue 10,3 (IC 95%: 2,8-37,5) respecto a los pacientes sin shock. La probabilidad de supervivencia a los 30 días de los pacientes con sepsis y shock séptico fue del 78 y 68%, respectivamente (long Rank < 0,001).

Conclusiones

En nuestra experiencia, la incorporación de la puntuación SOFA y el lactato a la nueva definición puede mejorar la valoración del riesgo de muerte hospitalaria.

Palabras clave:
Sepsis
Shock séptico
Escala SOFA
Lactato
Mortalidad hospitalaria

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