Search

Objectives: To compare the incidence of healthcare-associated infections (HAI) and their outcomes between patients admitted to the ICU with sepsis and those admitted with non-sepsis diagnoses. Materials and methods: We performed a single-center, prospective, observational study of ICU patients at a tertiary level medical-surgical unit from April 2018 to October 2018. All patients admitted to the ICU with a length of stay (LOS) > 48 hours were included. Baseline data including demographics, co-morbidities, and severity of illness scores were collected. Index occurrence of HAI in all these patients was noted and data regarding organ support and patient outcomes were recorded. The incidence, complications, ICU LOS, and 30-day mortality of HAI were compared between the patients admitted to ICU originally with sepsis and non-sepsis diagnoses. Results: A total of 271 patients were evaluated in our study (N = 106 for the sepsis group and N = 165 for the non-sepsis group). No significant difference between the groups was found in the incidence of HAI (29.2% in sepsis group vs 24.4% in non-sepsis group; p = 0.07). Complications (acute kidney injury (AKI): 71 vs 45%; p = 0.01, shock: 81 vs 55%; p = 0.05, need for mechanical ventilation (MV): 30 vs 15%; p = 0.04) were more common in sepsis group compared to the non-sepsis group. The ICU LOS (12.2 ± 5.2 days vs 8.8 ± 2.05 days; p = 0.01) was significantly longer in the sepsis group. There was no significant difference in 30-day mortality between the groups (45 vs 25%; p = 0.07). Conclusions: The incidence of HAI seems to be similar between patients admitted with sepsis and non-sepsis diagnoses. However, patients admitted with sepsis develop higher rates of organ failure secondary to HAI and have a longer ICU LOS compared to patients admitted with non-sepsis diagnoses. The mortality rate of HAI did not differ between these two groups. [ABSTRACT FROM AUTHOR]

Objectives: In critically ill patients, acute kidney injury (AKI) and sepsis often coexist. This confounds the assessment of outcomes of both sepsis and AKI in these patients. Hence, in this study, we compare the outcomes of AKI with sepsis, AKI without sepsis, and sepsis without AKI against a control cohort comprising patients with neither AKI nor sepsis. Materials and methods: Prospective observational study conducted in our critical care unit (CCU) between January and July 2009. Data including demographic details, acute physiology and chronic health evaluation (APACHE) III score, presence of AKI, presence of sepsis, intensive care unit (ICU) length of stay (LOS), and outcomes were collected for all patients. Acute Kidney Injury Network (AKIN) criteria were used to define the presence of AKI and American College of Critical Care Medicine 2001 definition was used to define the presence of sepsis. Results: A total of 250 patients were included in the study and 8 patients were excluded from analysis as they were discharged from hospital against medical advice. The remaining 242 patients (mean age 52.8 ± 17 years; 61.6% male; APACHE III score: 48.2 ± 24.1) were analyzed, and AKI was seen in 111 patients (45.8%). Among the patients with AKI, 55.8% (62/111) had sepsis and 44.2% (49/111) had nonseptic AKI. There was a higher need for renal replacement therapy (RRT) among patients with septic AKI in comparison to those with nonseptic AKI (19.3% vs 6.1%; p = 0.04), but no mortality difference was seen between the two groups (25.8% vs 20.4%, p = 0.5). Patients with sepsis and AKI had a significantly higher mortality (25.8%) compared to the patients with sepsis alone (5.6%; p < 0.01). Conclusion: Patients with septic AKI had a higher RRT requirement compared to patients with nonseptic AKI, but no significant differences in mortality were seen between the groups. Occurrence of AKI in septic patients substantially increases their mortality. [ABSTRACT FROM AUTHOR]