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Reliability of criteria for predicting persistent or recurrent sepsis
Archives of Surgery (Chicago, Ill. : 1960)
|January 1, 1985
Summary
Predicting sepsis eradication is crucial for surgical infection treatment. Normal temperature, white blood cell (WBC) count, and specific differential blood smear parameters reliably indicate successful sepsis eradication post-antibiotic therapy.
Area of Science:
- Infectious Diseases
- Clinical Medicine
- Microbiology
Background:
- Sepsis is a life-threatening condition requiring effective antibiotic treatment.
- Predicting sepsis eradication is vital for patient outcomes after surgical infections.
- Current predictors for sepsis eradication lack consistent reliability.
Purpose of the Study:
- To identify reliable predictors of sepsis eradication in patients with surgical infections.
- To evaluate the role of clinical and laboratory parameters in predicting sepsis recurrence.
- To establish criteria for safe discontinuation of antibiotic therapy.
Main Methods:
- Review of 2,567 patient charts from 11 prospective clinical trials.
- Analysis of temperature, WBC count, differential blood smear, renal and hepatic function, arterial gases, and clotting factors.
- Assessment of sepsis recurrence rates at antibiotic discontinuation and hospital discharge.
Main Results:
- Sepsis recurred in 19% with normal temperature, 3% with normal temperature and WBC count.
- No recurrence was observed when temperature, WBC count, and differential smear (<73% granulocytes, <3% immature forms) were normal.
- Recurrence rates at hospital discharge were 8%, 2%, and 0% for the same criteria.
Conclusions:
- Normal rectal temperature, WBC count, and specific differential blood smear findings are reliable predictors of sepsis eradication.
- These criteria can guide the safe discontinuation of antibiotic therapy for surgical infections.
- Utilizing these parameters can minimize the risk of sepsis recurrence.