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Sepsis and septic shock in emergency departments of Mexico: a multicenter point prevalence study
Luis A Gorordo-Delsol1,2, Graciela Merinos-Sánchez2,3, Ricardo A Estrada-Escobar3
1Adult Intensive Care Unit, Hospital Juárez de México, Secretaría de Salud.
Introduction:
Sepsis is one of the main reasons for consultation at emergency departments.
Objective:
To identify the prevalence of sepsis in emergency departments of Mexico.
Method:
Cross-sectional study with a 30-day follow-up of patients diagnosed with sepsis or septic shock; demographic variables, management and outcomes were analyzed.
Results:
In 68 emergency departments analyzed, 2379 patients were attended to, out of whom 307 had sepsis. The prevalence of sepsis was 12.9 %, and overall mortality was 16.93 %, which in the cases of sepsis was 9.39 %, and in those of septic shock, 65.85 %; no significant differences were identified in demographic variables or type of hospital. A significantly higher fluid balance was observed within the first three hours in those patients who died, as well as a lack of adherence to international resuscitation recommendations.
Conclusions:
A high prevalence of sepsis was found in Mexican emergency departments. Mortality of patients with septic shock was similar and even higher than that internationally reported.
IntroduccióN:
La sepsis es una de las principales causas de consulta en los servicios de urgencias médicas.
Objetivo:
Identificar la prevalencia de la sepsis en servicios de urgencias médicas de México.
MéTodo:
Estudio transversal con seguimiento a 30 días de los pacientes con diagnóstico de sepsis o choque séptico; se analizaron las variables demográficas, el manejo y los desenlaces.
Resultados:
En 68 servicios de urgencias médicas analizados se atendió a 2379 pacientes, de los cuales 307 presentaron sepsis. La prevalencia de la sepsis fue de 12.9 %, con mortalidad global de 16.93 %, que en los casos de sepsis fue de 9.39 % y en los de choque séptico, de 65.85 %; no se identificaron diferencias significativas en las variables demográficas o tipo de hospital. Se observó balance hídrico alto en las primeras tres horas y falta de apego a las recomendaciones internacionales de reanimación superior en los pacientes que fallecieron.
Conclusiones:
Se encontró alta prevalencia de la sepsis en los servicios de urgencias médicas mexicanos. La mortalidad de los pacientes con choque séptico fue similar e, incluso, mayor a la reportada internacionalmente.
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