Intr
It is considered that the severity of septic CIPs is higher than the overall CIPs requiring ICU admission. Nevertheless, the impact of the OP over the severity of the SS perhaps has not been sufficiently analyzed and evaluated.
Objectives
To evaluate the impact of the OP in the evolution of the SS of the CIPs.
Methods
· Study: prospective, analytical, longitudinal, and observational
· Period: January 1-2011 / June 30-2014 (42 months)
· SETTING. Medical/Surgical ICU
· Population: 2559 CIPs admitted consecutively to the ICU; sample: 484 CIPs with SS.
· Exclusión criteria: CIPs < 16 y., major burn CIPs, incomplete clinical documentation, and voluntary discharge.
· Variables analyzed:
a) Age
b) Hospital mortality
c) Case - mix: metabolic acidosis, total parenteral nutrition, intra-abdominal pressure (IAP), blood products, cultures, cardiac output, renal replacement therapy (RRT), advanced life support (ALS), FGC, FBC,
e) Organ dysfunction: SOFA and LODS
f) Limitation of life support (LLS).
· Statistical analysis: Ji squared and contrast of means (Student's t)
· Limitations of the study: absence of critically burned patients and pediatric CIPs
Results
Global CIPs: 2559; sepsis CIPs: 484; non sepsis CIPs: 2075
SOFA: Global (2.70), septic CIPs (5,32), non-septic CIPs (1,90)
LODS: Global (1.37), septic CIPs (2,78), non-septic CIPs (0,94)
Table 1
| Global | % | SS | % | SS with OP | % | SS witout OP | % | p value | |
|---|---|---|---|---|---|---|---|---|---|
| N | 2559 | 100 | 484 | 18,9 | 130 | 26,9 | 354 | 73,1 | |
| Age | 65,88 | 16,7 | 73,5 | 13,1 | 73,18 | 11,4 | 73,64 | 13,7 | NS |
| Mortality | 182 | 7,1 | 120 | 24,8 | 39 | 30,0 | 81 | 22,9 | NS |
| RRT | 91 | 3,6 | 70 | 14,6 | 20 | 15,8 | 50 | 14,1 | NS |
| TPN | 467 | 18,2 | 184 | 38,0 | 90 | 69,3 | 94 | 26,5 | 0,0001 |
| IAP | 136 | 5,3 | 101 | 20,8 | 37 | 28,6 | 64 | 18,1 | 0,012 |
| Metb acid | 955 | 37,3 | 368 | 76,0 | 113 | 86,9113 | 255 | 72,0 | 0,0006 |
Table 2
| Global | % | SS | % | SS with OP | % | SS witout OP | % | p value | |
|---|---|---|---|---|---|---|---|---|---|
| Blood products | 500 | 19,5 | 216 | 44,6 | 83 | 63,8 | 133 | 37,6 | 0,0001 NS NS |
| Cultures | 689 | 26,9 | 456 | 94,2 | 119 | 91,5 | 337 | 95,2 | NS |
| Pericardiocent. | 8 | 0,3 | 3 | 0,6 | 2 | 1,5 | 1 | 0,9 | NS |
| ALS | 85 | 3,3 | 42 | 8,7 | 16 | 12,3 | 26 | 7,3 | 0,085 |
| FGC | 54 | 2,1 | 28 | 5,8 | 8 | 6,1 | 20 | 5,6 | NS |
| FBC | 61 | 2,3 | 47 | 9,7 | 12 | 9,2 | 35 | 9,9 | NS |
| LLS | 220 | 8,6 | 122 | 25,2 | 41 | 31,5 | 81 | 22,9 | 0,0518 |
Conclusions
1) The OP conditions not age or mortality of CIPs with SS.
2) Metabolic acidosis and the need of TPN, IAP and blood products are higher in the SS with OP.
3) Cultures, RRT, ALS, FGC, and FBC are applied equally in both groups.
4) The LLS is applied more in the SS with OP.
References
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