Sepsis in a Combined Medical and Surgical High Dependency/Intensive Care Unit in Singapore: A Cohort Study and Survival Analysis

Abstract

Xiao Jiang,1 Faheem Ahmed Khan,1 Min Qi Ow,2 Hermione Mei Niang Poh2 1Department of Intensive Care Medicine, Ng Teng Fong General Hospital, Singapore; 2Department of Medical Informatics, Ng Teng Fong General Hospital, SingaporeCorrespondence: Xiao Jiang, Department of intensive Care Medicine, Ng Teng Fong General Hospital, Tower B, Level4, ICM office, 1 Jurong East Street 21, 609606, Singapore, Email [email protected]: Sepsis is a common indication for intensive care unit (ICU) admission and is associated with significant mortality and morbidity. The aim of our study was to first assess the incidence, severity, short-term and long-term mortality of sepsis in a combined medical and surgical high dependency/ ICU in Singapore, and to identify factors associated with increasing short-term and long-term mortality.Methods: All admissions from July 1 to December 31, 2017 were retrospectively screened and clinical data were collected. Patients were followed up until 3 years post ICU admission.Results: Of a total 1526 admissions, 281 had infection at ICU admission, and 254 (16.6%) fulfilled sepsis-3 criteria for sepsis. A total of 141 (9.2%) had septic shock. The 30-day, 1-year, 2-year and 3-year mortality of sepsis patients were 19.3%, 25.2%, 30.3% and 32.3%, respectively. Lung was the most common site of infection. Compared with 30-day sepsis survivors, non-survivors were older (median age 70 vs 63, P 1 and unplanned ICU re-admission were associated with increasing 3-year mortality in 30-day survivors.Conclusion: Our retrospective cohort single center study first reported sepsis admission incidence of 16.6% in a combined medical and surgical high dependency/ICU in Singapore, with significant short-term and long-term mortality. Lung infection was an independent risk factor for both 30-day and 3-year mortality.Keywords: sepsis, septic shock, incidence, severity, mortality, intensive care unit

Keywords

• sepsis
• septic shock
• incidence
• severity
• mortality
• intensive care unit