Epidemiological and clinical profile of patients with suspected sepsis and septic shock in a hospital emergency
DOI:
https://doi.org/10.5935/1415.2762.20210063Keywords:
Nursing, Emergency Service, Hospital, Shock, Septic, Patient CareAbstract
Objective: to analyze clinical and demographic characteristics and compliance with the ‘Surviving
Sepsis Campaign’ in suspected or confirmed cases of sepsis and septic shock recorded in medical records
of a hospital emergency. Method: quantitative, descriptive study. The sample consisted of 127 medical
records of adult patients admitted to a hospital emergency from June to October 2019. For data
analysis, frequencies, mean, standard deviation, chi-square test and Kruskal-Wallis test were used.
Results: the cases of sepsis and septic shock had the pulmonary as their main focus. The predominant
clinical diagnosis was infection with organ dysfunction. The predominant clinical outcome was
hospital discharge. The performance of measures recommended by the Sepsis Survival Campaign in
the first hour after the suspected diagnosis - collection of lactate, administration of antibiotics and
collection of blood cultures - was recorded in 10 (7.9%) medical records. Conclusion: knowledge of the
epidemiological characteristics of suspected or confirmed cases of sepsis and septic shock showed that
the clinical practice of the professionals involved was not in accordance with the conduct recommended
by the Surviving Sepsis Campaign.
Downloads
References
1- Singer M, Deutschman CS, Seymou CW, Shankar-Hari M, Annane
D, Bauer M, Bellomo R, et al. The Third International Consensus
Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA.
2016[citado em 2020 jul. 09];315(8):801-10. Disponível em: https://
jamanetwork.com/journals/jama/fullarticle/2492881
2- Shankar-Hari M, Gary S, Phillips MAS, Seymour CW, Liu VX,
Deutschman CS, et al. Sepsis definitions task force. Developing a
new definition and assessing new clinical criteria for septic shock:
for the third international consensus definitions for sepsis and septic
shock (Sepsis-3). JAMA. 2016[citado em 2021 ago. 15];315(8):775-
87. Disponível em: https://doi: 10.1001/jama.2016.0289
3- Instituto Latino Americano de Sepse. Sepse: um problema de saúde
pública. São Paulo: ILAS; 2017[citado em 2020 jul. 09]. Disponível
em: http://diamundialdasepse.com.br/assets/downloads/Flyer-A5-
profissionais-saude.pdf
4- Instituto Latino Americano de Sepse. Relatório Nacional Implementação
de protocolos gerenciados sepse. São Paulo: ILAS; 2018[citado em
2020 jul. 09]. Disponível em: http://www.ilas.org.br/assets/arquivos/
relatorio-nacional/relatorio-nacional-final.pdf
5- Rhee C, Travis MJ, Hamad Y, Pande A, Varon J, O’Brien C, et al.
Prevalence, underlying causes, and preventability of sepsisassociated
mortality in US acute care hospitals. JAMA. 2019[citado
em 2021 jul. 26];2(2):1-14. Disponível em: https://pubmed.ncbi.nlm.nih.
gov/30768188/ DOI: https://doi:10.1001/ jamanetworkopen.2018.7571
6- Klimpel J, Weidhase L, Bernhard M, Gries A, Petros S. The impact of
the Sepsis-3 definition on ICU admission of patients with infection.
Scand J Trauma Resusc Emerg Med. 2019[citado em 2020 jul.
09];27(98). Disponível em: https://sjtrem.biomedcentral.com/
articles/10.1186/s13049-019-0680-9
7- Zonta FNS, Velasquez PGA, Velasquez LG, Demetrio LS, Miranda
D, Silva MCBD. Epidemiological and clinical characteristics of
sepse in a public hospital of Paraná. Rev Epidemiol Control Infec.
2018[citado em 2020 jul. 08];8(3):224-31. Disponível em: https://
online.unisc.br/seer/index.php/epidemiologia/article/view/11438
8- Carneiro AH, Póvoa P, Gomes JA. Dear Sepsis-3, we are sorry to
say that we don’t like you. Rev Bras Ter Int. 2017[citado em 2020
jul. 09];29(1):4-8. Disponível em: https://www.scielo.br/scielo.
php?script=sci_arttext&pid=S0103-507X2017000100004
9- Santos MCS, Sanches CT, Moraes URO, Albanese SPR, Carrilho
CMDM, Volpato MP, et al. Clinical aspects and the origin of sepsis
patients treated at a university hospital. Acta Paul Enferm. 2019[citado
em 2020 jul. 10];32(1):65-71. Disponível em: https://www.scielo.br/
scielo.php?script=sci_arttext&pid=S0103-21002019000100065&lng=
en&nrm=iso&tlng=en
10- Malta M, Cardoso LO, Bastos FI, Magnanini MMF, Silva CMP. STROBE
initiative: guidelines on reporting observational studies. Rev Saúde Pública.
2010[citado em 2020 jul. 10];44(3):559-65. Disponível em: https://www.
scielo.br/scielo.php?script=sci_arttext&pid=S0034-89102010000300021
11- Nassar SM, Wronscki VR, Ohira M. SEstatNet- Sistema Especialista
para o Ensino de Estatística na Web. Florianópolis: SEstatNet;
2020[citado em 2020 jul. 09]. Disponível em: http://sestatnet.ufsc.br
12- Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign
Bundle: 2018 update. Intensive Care Med. 2018[citado em
2020 jul.15];44:925-8 Disponível em: https://journals.lww.
com/ccmjournal/Fulltext/2018/06000/The_Surviving_Sepsis_
Campaign_Bundle_2018_Update.21.aspx
13- Carbó M, Fresco L, Osorio G, Monclús E, Ortega M. Predictors
of mortality in emergency department patients with sepsis scored
2 or 3 on the Quick Sequential Organ Failure Assessment scale.
Emergências. 2020[citado em 2020 jul. 05];32(3):169-76.
Disponível em: https://pubmed.ncbi.nlm.nih.gov/32395924/
14- Santos AM, Souza GRBO, Oliveira AML. Sepsis in adult patients
in the intensive care unit: clinical characteristics. Arq Med Hosp
Fac Cienc Med Santa Casa São Paulo. 2016[citado em 2020 jul.
05];61:3-7. Disponível em: http://arquivosmedicos.fcmsantacasasp.
edu.br/index.php/AMSCSP/article/view/125/0
15- Barros LLS, Maia CSF, Monteiro MC. Risk factors associated
to sepsis severity in patients in the Intensive Care Unit. Cad Saúde Colet.
2016[citado em 2020 jul 05];24(4):388-96. Disponível em: https://www.
scielo.br/scielo.php?script=sci_arttext&pid=S1414-462X2016000400388
16- Rhode A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer
R, et al. Surviving Sepsis Campaign: International Guidelines for
Manegement of Sepsis and Septic Shock: 2016. Intensive Care Med.
2017[citado em 2020 jul. 10];43:304-77. Disponível em: https://
journals.lww.com/ccmjournal/Fulltext/2017/03000/Surviving_
Sepsis_Campaign_International.15.aspx
17- West TE, Wikraiphat C, Tandhavanant S, Ariyaprasert P, Suntornsut P,
Okamoto S, et al. Patient characteristics, management, and predictors
of outcome from severe community-onset staphylococcal sepsis in
northeast Thailand: a prospective multicenter study. Am J Trop Med
Hyg. 2017[citado em 2020 jul. 05];96(5):1042-9. Disponível em:
https://pubmed.ncbi.nlm.nih.gov/28167592/
18- Seymour CW, Gesten F, Prescott HC, Friedrich ME, Iwashyna TJ et al.
Time to treatment and mortality during mandated emergency care
for sepsis. N Engl J Med. 2017[citado em 2020 jul. 08];376:2235-
44. Disponível em: https://www.nejm.org/doi/full/10.1056/
nejmoa1703058
19- Branco MJC, Lucas APM, Marques RMD, Sousa PP. The role of the
nurse in caring for the critical patient with sepsis. Rev Bras Enferm.
2020[citado em 2021 jul. 01];73(4) Disponível em: https://www.scielo.
br/j/reben/a/vpDRwFcxG6TFRXyZhyVtbXQ/?lang=pt&format=pdf
20- Carnio EC. New perspectives for the treatment of the patient
with sepsis. Rev Latino Am-Enferm. 2019[citado em 2020 jan.
08];27:e3082. Disponível em: https://www.scielo.br/scielo.
php?script=sci_arttext&pid=S0104-11692019000100200
21- Trochet C, Techer V, Roudet A, Gavazzi G. Septic shock, organisation
and nursing care. Rev Infirm. 2020[citado em 2021 jun. 25];69(260-
261):22-4. Disponível em: https://pubmed.ncbi.nlm.nih.
gov/32600590/
22- Brown RM, Semler MW. Fluid Management in Sepsis. J Intensive Care
Med. 2019[citado em 2021 jun. 26];34(5):364-73. Disponível em:
https://journals.sagepub.com/doi/abs/10.1177/0885066618784861
23- Souza ALT, Amário AAS, Covay DLA, Veloso LM, Silveira LM,
Stabile AM. Nurses’ knowledge on septic shock. Ciênc Cuid Saúde.
2018[citado em 2020 jul. 12];17(1):1-7. Disponível em: http://www.
periodicos.uem.br/ojs/index.php/CiencCuidSaude/article/view/39895
24- Westphal GA, Pereira AB, Fachin SM, Barreto ACC, Bornschein
ACGJ, Caldeira FM. Characteristics and outcomes of patients with
community-acquired and hospital-acquired sepsis. Rev Bras Ter
Intensiva. 2019[citado em 2020 jul. 12];31(1):71-8. Disponível em:
https://www.scielo.br/scielo.php?script=sci_abstract&pid=S0103-
507X2019000100071&lng=es&nrm=1
25- Fernandes TM, Ribeiro RM, Comin MF, Dagostin VS, Ceretta LB,
Tessmann M. Análise do perfil de pacientes que sobrevivem à sepse.
Rev Adm Saúde. 2021[citado em 2021 jul. 11];21(82):e279. Disponível
em: https://cqh.org.br/ojs-2.4.8/index.php/ras/article/view/279/412
Links
Facebook
Instagram
Twitter
