A study to determine the ethiology and outcome of adult patients presenting with Sepsis

Abstract

BACKGROUND Sepsis accounts for a significant burden of morbidity and mortality. In developed countries, it has been implicated as the second leading cause of non-cardiac death. Mortality from sepsis is on the increase with mortality rate of 33-61%. In spite of the high burden of sepsis in sub-Saharan African, data regarding the etiology and outcome of septic patients is limited. We conducted a prospective cohort study to look at the etiology and outcome of patients presenting with sepsis to UTH, in Lusaka, Zambia. OBJECTIVES To describe the aetiology, characteristics and outcomes of patients presenting with sepsis to the department of medicine. METHODS/ RESULTS Patients who met the inclusion criteria for sepsis were recruited into the study. Vital signs and management details were recorded and bloods were drawn for urea, Creatinine, full blood count and culture. A total of 161 patients were enrolled. 110 (68 %) of the patients were HIV positive with 23 (14%) who had unknown status. Mortality in our cohort of septic patients was at 40.4. Important predictors for in-patient mortality were: low GCS on admission [OR 11.2(3.5-36.4)] and Blood culture being positive [OR 2.38(1.14-4.95)]. CONCLUSION Most of the septic patients presenting to UTH had advanced immunosuppression (WHO stage 3 or 4) and had a high mortality rate. Staphylococcus aureus and streptococcus pneumoniae were the highest isolates in our study. Identified predictors of in-patient mortality could be used to try and improve outcome of septic patients admitted to UTH.