Abstract

MONTIEL-JAROLIN, Dora; QUINTANA, Rubén  and  SAMUDIO, Margarita. Clinical characteristics and mortality in patients with hospital-onset and community-acquired sepsis in a reference hospital in the period 2016-2017. Rev. cient. cienc. salud [online]. 2022, vol.4, n.1, pp.54-62. ISSN 2664-2891.  https://doi.org/10.53732/rccsalud/04.01.2022.54.

Introduction. Sepsis continues to present a high mortality despite advances in treatment. Objective: To determine the clinical characteristics and mortality of patients with sepsis admitted to a reference hospital. Methodology. Retrospective analytical study of adult patients diagnosed with sepsis admitted to the Hospital Nacional in the period 2016-2017. Results. 160 patients were studied, 105 (65.6%) had community-acquired sepsis and 55 (34.4%) hospital-onset sepsis. There was a higher proportion of males (60.7%) among patients with hospital-onset sepsis, there was no significant difference in the mean age (50.15±18.0 vs 53.5 ± 21.4). The frequency of a risk factor/comorbidity (76.8% vs 53.8%), positive blood culture (38.2% vs 17.1%) and positive sputum (25.5% vs 3.8%) were significantly higher in patients with hospital-onset sepsis. There was no difference in the pulmonary or gastrointestinal infection focus, however, the infection focus in the skin and soft tissues (3.6% vs 20.2%) and uro-genital (1.8% vs 17.3%) were significantly more frequent in community sepsis. Staphylococcus aureus and SCN were the most frequent microorganisms, Acinetobacter baumanii and Pseudomona aeruginosa were significantly more frequent in patients with nosocomial sepsis. Mortality was significantly associated with hospital-onset sepsis (60.7% vs 40.9%; p=0.012; OR: 2.33 (95%CI: 1.19-4.56)); immunosuppression (76.0% vs 43.0%; p=0.002; OR: 4.20 (95%CI: 1.58-11.19)) and septic shock (70.4% vs 1.9%; <0.001; OR: 121 (95%CI: 16.0-914)). Conclusion. Mortality was high in this series, significantly more frequent in hospital-onset sepsis, immunocompromised and with septic shock patients.

Keywords : sepsis; cross infection; community-acquired infections; mortality.

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