| Author | Machado, Flavia R. | |
| Author | Cavalcanti, Alexandre Biasi | |
| Author | Bozza, Fernando A. | |
| Author | Ferreira, Elaine M. | |
| Author | Carrara, Fernanda Sousa Angotti | |
| Author | Sousa, Juliana Lubarino | |
| Author | Caixeta, Noemi | |
| Author | Salomao, Reinaldo | |
| Author | Angus, Derek C. | |
| Author | Azevedo, Luciano Cesar Pontes | |
| Author | SPREAD Investigators and the Latin American Sepsis Institute Network | |
| Access date | 2019-08-05T13:12:41Z | |
| Available date | 2019-08-05T13:12:41Z | |
| Document date | 2017 | |
| Citation | MACHADO, Flavia R. et al. The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study. Lancet Infectious Diseases, v. 17, n. 11, p. 1180-1189, Nov. 2017. | pt_BR |
| ISSN | 1473-3099 | pt_BR |
| URI | https://www.arca.fiocruz.br/handle/icict/34602 | |
| Description | Fernando Augusto Bozza. Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Documento produzido em parceria ou por autor vinculado à Fiocruz, mas não consta a informação no documento. | pt_BR |
| Language | eng | pt_BR |
| Publisher | Elsevier | pt_BR |
| Rights | open access | pt_BR |
| Title | The epidemiology of sepsis in Brazilian intensive care units (the Sepsis PREvalence Assessment Database, SPREAD): an observational study | pt_BR |
| Type | Article | pt_BR |
| DOI | 10.1016/S1473-3099(17)30322-5 | |
| Abstract | Background: The sepsis burden on acute care services in middle-income countries is a cause for concern. We estimated incidence, prevalence, and mortality of sepsis in adult Brazilian intensive care units (ICUs) and association of ICU organisational factors with outcome. Methods: We did a 1-day point prevalence study with follow-up of patients in ICU with sepsis in a nationally representative pseudo-random sample. We produced a sampling frame initially stratified by geographical region. Each stratum was then stratified by hospitals’ main source of income (serving general public vs privately insured individuals) and ICU size (ten or fewer beds vs more than ten beds), finally generating 40 strata. In each stratum we selected a random sample of ICUs so as to enrol the total required beds in 1690 Brazilian adult ICUs. We followed up patients until hospital discharge censored at 60 days, estimated incidence from prevalence and length of stay, and generated national estimates. We assessed mortality prognostic factors using random-effects logistic regression models. Findings: On Feb 27, 2014, 227 (72%) of 317 ICUs that were randomly selected provided data on 2632 patients, of whom 794 had sepsis (30·2 septic patients per 100 ICU beds, 95% CI 28·4–31·9). The ICU sepsis incidence was 36·3 per 1000 patient-days (95% CI 29·8–44·0) and mortality was observed in 439 (55·7%) of 788 patients (95% CI 52·2–59·2). Low availability of resources (odds ratio [OR] 1·67, 95% CI 1·02–2·75, p=0·045) and adequacy of treatment (OR 0·56, 0·37–0·84, p=0·006) were independently associated with mortality. The projected incidence rate is 290 per 100000 population (95% CI 237·9–351·2) of adult cases of ICU-treated sepsis per year, which yields about 420000 cases annually, of whom 230000 die in hospital. Interpretation: The incidence, prevalence, and mortality of ICU-treated sepsis is high in Brazil. Outcome varies considerably, and is associated with access to adequate resources and treatment. Our results show the burden of sepsis in resource-limited settings, highlighting the need to establish programmes aiming for sepsis prevention, early diagnosis, and adequate treatment. | pt_BR |
| Affilliation | Universidade Federal de São Paulo. Anesthesiology, Pain, and Intensive Care Department. São Paulo, SP, Brazil / Latin America Sepsis Institute. São Paulo, SP, Brazil / Brazilian Research in Intensive Care Network. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil / Brazilian Research in Intensive Care Network. São Paulo, SP, Brazil / Hospital do Coração. Research Institute. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil / Brazilian Research in Intensive Care Network. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | Universidade Federal de São Paulo. Infectious Disease Department. São Paulo, SP, Brazil / Latin America Sepsis Institute. São Paulo, SP, Brazil. | pt_BR |
| Affilliation | University of Pittsburgh. Department of Critical Care Medicine. Pittsburgh, PA, USA . | pt_BR |
| Affilliation | Latin America Sepsis Institute. São Paulo, SP, Brazil / Brazilian Research in Intensive Care Network. São Paulo, SP, Brazil / Hospital Sírio Libanês. São Paulo, SP, Brasil. | pt_BR |
| Subject | Sepsis | pt_BR |
| Subject | ICU | pt_BR |
| Subject | Brazil | pt_BR |
| e-ISSN | 1474-4457 | |
| Embargo date | 2020-08-05 | |
