A Study of Clinical and Laboratory Profile in Septicemic Patients in Tertiary Care Hospital
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 7
Abstract
Introduction: Sepsis is the most frequently encountered medical condition in the intensive care setting and the most common cause of death among hospitalized patients in non-cardiac intensive care units (ICUs), which is preventable through early evaluation of patient. Objective: We evaluated the clinical profile, laboratory parameters and underlying risk factors associated with mortality in septicemic patients. Material and Methods: The study was conducted at Medical Intensive Care Unit (ICU) in a tertiary care hospital in North India. A total of hundred consecutive septicemic patients admitted to the ICU were enrolled in this study. Patients were evaluated for clinical profile, laboratory parameters, APACHE II score, underlying risk factors and all cause mortality. Results: In our study population, 56 were males and 44 were females. 64% patients were infected with gram-negative and 36% were infected with gram-positive bacteria. In the study subjects, there were 58% mortality cases and 42% responded to treatment. In our study, liver illness was the most common medical illness (32%) followed by renal illness (30%). The abdominal system was involved as a primary system in 38% of the subjects whereas the respiratory and cardiovascular system was involved in 18% and 8% of the subjects respectively. Maximum mortality (85.71%) was seen in the age group of 41-50 years. Patients with APACHE-II score >65 shows 100% mortality whereas no mortality was seen in patients with APACHE-II score <44 (p<0.001). In this study, 71.88% mortality was seen in patients with gram-negative bacterial infection and 33.33% in gram-positive bacterial infection (p<0.008). In the present study, similar mortalities were observed in the respiratory, cardiovascular and abdominal system i.e. 77.78% (14/18), 75% (6/8) and 78.95% (30/38), respectively. Higher mortality was recorded in patients with hepatic (81.25%) and renal (73.33%) illnesses. Conclusion: The study showed that in our critical care setting, abdominal system was the most common system involved in septicemic patients. Maximum mortality was seen in patients with hepatic and renal involvement. APACHE II score helped in identifying the patients with high risk of mortality. So the early evaluation of patient and selection of organ specific appropriate antibiotic therapy with best supportive care can reduce the mortality in the septicemic patients.
Authors and Affiliations
Dr. Siddharth Sharma
Keywords
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