Comparison of Clinical Characteristics and Treatment Outcomes of Sepsis or Septic Shock Patients between Those Diagnosed by2012 Criteria and Those by 2016 Criteria
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Abstract
Objective: To compare clinical characteristics and treatment outcomes of sepsis or septic shock patients who were qualified by the diagnostic criteria in 2012 and those qualified by the diagnostic criteria in 2016. Method: This study was a prospective cohort study in patients with sepsis or septic shock receiving initiated treatment at emergency room, Siriraj hospital during July 1st, 2016 to October 31st, 2016. The data collected were demographics, causative microorganisms, categories of sepsis, source of infections, complications and treatment outcomes. Results: A total of 200 patients were classified into 2 groups according to their SOFA (Sequential Organ Failure Assessment) scores. SOFA scores 0-1 were qualified by diagnostic criteria in 2012, whereas SOFA scores > 2 were qualified by diagnosis criteria in 2016. Factor associated with SOFA scores > 2 included hypertension (P=0.029), renal disease (P=0.016), liver disease (P=0.028) and indwelling urinary catheter (P=0.041). The most common causative gram-negative and gram positive bacteria identified from specimens were Escherichia coli (37.4%) and Staphylococcus aureus (MSSA) (11.7%), respectively. Sources of infection and complications that associated with SOFA scores > 2 were intra-abdominal infection (P=0.019), acute kidney injury (P<0.001), hyponatremia (P=0.017), anemia (P=0.025) and metabolic acidosis (P=0.037). SOFA scores > 2 was associated with qSOFA scores > 2 (P<0.001). Patients with SOFA scores > 2 were had a 3.64 fold higher mortality than patients with a SOFA scores 0–1 (OR: 3.64, 95%CI: 1.21 – 10.91, P=0.015). Conclusion: SOFA and qSOFA scores showed concordant results in the evaluation of sepsis patients. Risk factors of having SOFA scores > 2 were underlying disease and complication. This group of patients had a higher mortality rate than those with SOFA scores 0–1. Accordingly, they should be attended by healthcare providers.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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