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Sepsis in Internal Medicine wards: current knowledge, uncertainties and new approaches for management optimization
- Publication Year :
- 2017
- Publisher :
- Taylor and Francis Ltd, 2017.
-
Abstract
- Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving. This is due to Internists' increased adherence to guidelines and "bundles". The routine use of SOFA score helps physicians in the definition of septic patients, even if the optimal score has still to come. Point-of-care ultrasonography, lactates, procalcitonin and beta-d-glucan are of help for treatment optimization. The purpose of this narrative review is to focus on the management of sepsis in Internal Medicine departments, particularly on crucial concepts regarding diagnosis, risk assessment and treatment. Key Messages Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The prevalence of sepsis is constantly increasing, affecting more hospital patients than any other disease. At least half of patients affected by sepsis are admitted to Internal Medicine wards. Adherence to guidelines, routine use of clinical and lab scores and point-of-care ultrasonography are of help for early recognition of septic patients and treatment optimization.
- Subjects :
- medicine.medical_specialty
Point-of-Care Systems
Settore BIO/09 - FISIOLOGIA
Population
Risk Assessment
Severity of Illness Index
Procalcitonin
Sepsis
03 medical and health sciences
0302 clinical medicine
qSOFA
Cost of Illness
Intensive care
Internal medicine
medicine
Internal Medicine
Prevalence
SOFA
Humans
030212 general & internal medicine
Hospital Mortality
Risk factor
Intensive care medicine
education
Ultrasonography
education.field_of_study
business.industry
Organ dysfunction
030208 emergency & critical care medicine
General Medicine
medicine.disease
Anti-Bacterial Agents
Hospitalization
Intensive Care Units
Practice Guidelines as Topic
SOFA score
medicine.symptom
Risk assessment
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....0e73b7bbf2cd38148d1b98b1859d1cc4