Risk factors associated to sepsis severity in patients in the Intensive Care Unit

Abstract Introduction sepsis is a serious public health problem, leading cause of death in Intensive Care Unit (ICU) worldwide. Objective this study evaluated the aggravation and mortality of sepsis patients in ICU, relating to risk factors, different etiologies and therapies. Methodology the study was observational descriptive, and evaluated the cases of sepsis (sepsis, severe sepsis and septic shock) from January 2009 to December 2010. Results of the 212 patients hospitalized in ICU, 181 presented sepsis at different severities, whose sepsis mortality in the ICU was 63%, especially in patients with septic shock (53%), followed by severe sepsis (8.3%). Moreover, the risk factors associated with the aggravation of sepsis were older than 65 years, longer ICU hospitalization time, high frequency of comorbidities and the use of invasive procedures. The highest consumption of antibiotics was carbapenems, and the main isolated multiresistant strains were MRSA, VRE, P. aeruginosa and A. baumannii resistant to carbapenems. Conclusion this study showed a high mortality from sepsis patients in the ICU, especially in patients with septic shock with comorbidities, who underwent invasive procedures and longer hospitalization time.

### 摘要
引言：脓毒症（sepsis）是一类严重的公共卫生问题，为全球重症监护室（Intensive Care Unit, ICU）患者的首要致死原因。研究目的：本研究针对ICU脓毒症患者的病情恶化与死亡情况，探究其相关危险因素、不同致病病因及治疗方案。研究方法：本研究为观察性描述性研究，纳入2009年1月至2010年12月期间的脓毒症（含脓毒症、重度脓毒症及脓毒性休克）病例。研究结果：在212例ICU住院患者中，共181例存在不同严重程度的脓毒症，其ICU脓毒症病死率达63%，其中以脓毒性休克患者的病死率最高（53%），其次为重度脓毒症患者（8.3%）。此外，与脓毒症病情恶化相关的危险因素包括年龄超过65岁、ICU住院时长较长、合并症高发以及侵入性操作的应用。临床抗生素使用占比最高的类别为碳青霉烯类（carbapenems），主要分离得到的多重耐药菌株包括耐甲氧西林金黄色葡萄球菌（MRSA）、耐万古霉素肠球菌（VRE）、铜绿假单胞菌（P. aeruginosa）及耐碳青霉烯类鲍曼不动杆菌（A. baumannii）。研究结论：本研究结果显示，ICU脓毒症患者病死率较高，尤其是合并基础疾病、接受侵入性操作且住院时长较长的脓毒性休克患者。