[Results of severe sepsis treatment--two years of experience in a single centre].

Abstract

Background: Treatment of severe sepsis (SS) is a major challenge for an ITU, because of the high mortality. The severity of 55 is scored according to the number of organ systems that have failed. We analysed the results of treatment of SS in the ITU of the Upper Silesian Medical Centre, and compared them to previously reported data obtained from other centres.

Methods: Between 2008 and 2009, 45 SS cases were treated. Demographic data, laboratory tests and therapeutic routines were analysed.

Results: The overall mortality rate was 58%. There was a positive correlation between mortality, male gender and advanced age. The most common initial sources of infection were the respiratory system and abdominal cavities. Serious metabolic disturbance and central nervous system failure markedly affected prognosis. In 56% of cases, five or more organ systems were affected,

Discussion: Survival in SS is related to the number of affected organ systems. All patients were admitted in critical condition requiring respiratory and inotropic support. Despite strict application of the Surviving Sepsis Campaign (SSC) recommendations and a relatively short time from diagnosis to commencement of adequate treatment, the mortality rate was found to be higher than the European average, but comparable to that from the Polish registry.

Conclusions: Advanced age, male gender and intraperitoneal pathology worsened the prognosis in SS. Mortality was directly related to the number of organ systems involved, and the number of coexistent diseases. An interdisciplinary approach during diagnosis and a reduced time to the start of intensive treatment are essential for survival. Ready access to updated databases on SS enables regular reviews of the results of treatment and improvement of algorithms.