Sepsis in Haiti: Prevalence, treatment, and outcomes in a Port-au-Prince referral hospital
Sepsis in Haiti: Prevalence, treatment, and outcomes in a Port-au-Prince referral hospital
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DOI：
10.1016/j.jcrc.2016.09.031
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发表时间：
2017-04-01
影响因子：
3.7
通讯作者：
West, T. Eoin
中科院分区：
文献类型：
--
作者：
Papali, Alfred;Verceles, Avelino C.;West, T. Eoin
目的：发展中国家的脓毒症负担最重，但西半球的描述性数据很少。我们进行了一项回顾性队列研究，以阐明在城市转诊医院在太子港，Haiti.Materials和方法：我们研究了所有成人急诊科患者的遭遇，从2012年1月至3月的介绍，治疗和脓毒症的结果。我们的特点介绍，管理和结果使用单变量和多变量analysis.Results：1078例成人患者中，224例（20.8%）有脓毒症和99例（9.2%）有严重脓毒症。严重脓毒症的住院死亡率为24.2%。脑病是静脉输液的预测因子（校正比值比[OR]，5.63; 95%置信区间[CI]，1.46-21.76; P = 0.01），血压越低，输液时间越短。体温升高和血压降低预示着抗生素的使用。出现脑病（调整OR，6.92; 95% CI，1.94-24.64; P = .003），吸氧（校正OR，15.96; 95% CI，3.05-83.59; P = .001），粪便镜检（校正OR，45.84; 95%CI，1.43-146934; P = 0.03）预测严重脓毒症患者的死亡。我们的研究结果有助于全球脓毒症的知识基础，并揭示了高收入和低收入国家之间死亡率独立预测因素的相似性。(C)2016 Elsevier Inc. All rights reserved.
Purpose: Developing countries carry the greatest burden of sepsis, yet few descriptive data exist from the Western Hemisphere. We conducted a retrospective cohort study to elucidate the presentation, treatment, and outcomes of sepsis at an urban referral hospital in Port-au-Prince, Haiti.Materials and methods: We studied all adult emergency department patient encounters from January through March 2012. We characterized presentation, management, and outcomes using univariable and multivariable analyses.Results: Of 1078 adult patients, 224 (20.8%) had sepsis and 99 (9.2%) had severe sepsis. In-hospital mortality for severe sepsis was 24.2%. Encephalopathy was a predictor of intravenous fluid administration (adjusted odds ratio [OR], 5.63; 95% confidence interval [CI], 1.46-21.76; P = .01), and lower blood pressures predicted shorter time to fluid administration. Increasing temperature and lower blood pressures predicted antibiotic administration. Encephalopathy at presentation (adjusted OR, 6.92; 95% CI, 1.94-24.64; P = .003), oxygen administration (adjusted OR, 15.96; 95% CI, 3.05-83.59; P = .001), and stool microscopy (adjusted OR, 45.84; 95% CI, 1.43-146934; P = .03) predicted death in severe sepsis patients.Conclusions: This is the first descriptive study of sepsis in Haiti. Our findings contribute to the knowledge base of global sepsis and reveal similarities in independent predictors of mortality between high-and low-income countries. (C) 2016 Elsevier Inc. All rights reserved.