Characteristics and outcome of sepsis – A perspective from a tertiary care hospital in Pakistan

Objective: Sepsis accounts for a high rate of mortality with significant impact on health care across the world. Our objective was to determine clinical determinants of outcome of sepsis in a tertiary care setting. Design: Prospective, observational study. Place and Duration: A tertiary care University hospital catering to roughly 50,000 admissions per year with an intensive care unit [ICU] admitting around 1000 patients per year. The study was conducted from 2006-2007 Patients and Methods: We studied 99 patients in one year with sepsis and/or septic shock as per SCCM definitions. Patients were enrolled after informed consent. Data on patient characteristics such as ethnicity, site of infection, type of infecting organisms, presence of co-morbidities and severity of sepsis was collected. Final outcome was recorded in terms of recovery from sepsis or mortality. Association between patient characteristics and outcome was done using chi square test. Results: Sepsis patients belonged to six ethnic groups; no significant difference was found in mortality between these groups. At the time of enrolment, 69% of patients had sepsis and 30% had septic shock. Mortality due to sepsis/septic shock was 36.36% and was significantly associated with male gender [p=0.04] and presence of septic shock [p< 0.001]. The commonest site of infection leading to sepsis was the respiratory tract [48%]. Forty nine patients were culture positive showing higher frequency of gram negative [59%] compared to gram positive organisms [28%]. Conclusions: Majority of cases of sepsis arose from the respiratory tract infections; majority of culture-proven infections were due to gram negative bacteria and males were more likely to have a poor outcome in our cohort of sepsis patients. Outcome was not associated with ethnicity or presence or number of co-morbid conditions.