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Risk factors for mortality from sepsis in an intensive care unit in Ecuador A prospective study

Abstract:

To investigate risk factors for mortality from sepsis in an intensive care unit (ICU) in Quito-Ecuador and their association to adherence to Surviving Sepsis Campaign recommendations. Prospective cohort study of patients with severe sepsis/septic shock admitted to the ICU of a public Ecuadorian hospital from March, 2018 to March, 2019. Demographic, clinical, treatment, and outcome data were collected from patients’ health records. Patients were divided into 2 groups according to ICU survival or death. Log-binomial regression models were used to identify risk factors for mortality. In total, 154 patients were included. Patients who died in the ICU (n = 42; 27.3%) had higher sequential organ failure assessment score (median 11.5 vs 9; P < .01), more organ dysfunction (median 4 vs 3; P < .0001), and received greater volumes of fluid resuscitation in the first 6 hours (median 800 vs 600 mL; P = .01). Dysfunction of > 2 organs was a risk factor for mortality (relative risks [RR] 3.80, 95% CI 1.33–10.86), while successful early resuscitation (RR 0.32, 95% CI 0.15–0.70), successful empirical antibiotic treatment (RR 0.38, 95%CI 0.18–0.82), and antibiotic de-escalation (RR 0.28, 95%CI 0.13–0.61) were protective factors. Dysfunction of >2 organs was a risk factor for mortality from sepsis while successful early resuscitation and appropriate antibiotic treatment were protective.