Dados do Trabalho

Título

Comparison of hospital-acquired sepsis to community-acquired sepsis: characteristics of patients and in-hospital death

Objetivo

The objective of this study was to describe the characteristics, diagnostic tools, and mortality rates among adult patients admitted with hospital-acquired sepsis (HA) and community-acquired sepsis (CA).

Métodos

Retrospective study including adult patients diagnosed with sepsis between July 2022 and January 2023 in a tertiary hospital in Rio de Janeiro. Patients were included if they met at least two SIRS criteria and one qSOFA criteria. Data were collected from the EPIMED®️ system and sepsis protocol.

Resultados

204 adult patients with a diagnosis of sepsis were included (85 with HA and 119 with CA). Patients with HA were older (80.5 ± 19.38 years vs. 74.06 ± 15.29 years, p=0.008), had higher SAPS scores (65.8 ± 19.7 vs. 61.3 ± 12.5, p = 0.04), and had higher SOFA scores (7.38 ± 3.49 vs. 2.63 ± 1.47, p=0.0001). Mortality rate was higher in patients with HA compared to CA (54.11% vs. 14.28%, p= 0.03). The main factors associated with mortality in HA were cardiovascular disease (HR 2.43, 95% CI 1.21-4.94, p=0.01) and neoplasia (HR 2.69, 95% CI 1.33-5.40, p= 0.005). The AUROC for mortality was not significantly different between HA and CA sepsis for the SOFA score (AUROC: 0.675 vs 0.532), qSOFA (AUROC: 0.544 vs 0.508), and SIRS criteria (AUROC: 0.545 vs 0.542).

Conclusão

Patients with hospital-acquired sepsis were older and more critically ill compared to patients with community-acquired sepsis. Mortality rates were nearly three times higher in patients with hospital-acquired sepsis.