Evaluation of sepsis frequency and affecting factors in postoperative intensive care unit: A prospective observational study.

BACKGROUND

In our study, we aimed to evaluate the frequency of early postoperative sepsis, the factors affecting it and the outcomes of sepsis in patients treated in a postoperative intensive care unit (PICU).

METHODS

Postoperative patients treated in PICU between July 15, 2021 to July 14, 2022 were included in our prospective study. Patient data, demographic characteristics, operation, and anesthesia method characteristics were recorded and analyzed.

RESULTS

Eleven percent of the 1123 cases were infected, 6.4% had sepsis, and 5.3% had septic shock. It was determined that emergency operation, male gender, increased American Society of Anesthesiologists class, immunosuppression, increased frequency of peroperative blood product and colloid use, acute physiology and chronic health examination II, sequential organ failure assessment, CCI scores, blood urea nitrogen, creatinine, alanine aminotransferase, aspartate aminotransferase, C-reactive protein, Na, Cl, Ca, bilirubin, INR, albumin, platelet levels were associated with infection, sepsis, and septic shock (P < .05). In patients with sepsis and septic shock, the need and duration of invasive mechanical ventilation in PICU, the need for renal replacement therapy, steroid, sedation, muscle relaxant, blood product, albumin requirement, cardiac complications, PICU, intensive care unit, and hospital mortality were found to be high (P < .05). In multivariate logistic regression analysis for mortality, acute physiology and chronic health examination II score (odds ratio [OR], 1.17; 95% confidence interval [CI], 1.04-1.32, P = .006), sequential organ failure assessment score (OR, 1.32; 95% CI, 1.06-1.64, P = .010), body mass index (OR, 0.85; 95% CI, 0.79-0.91, P < .001), blood urea nitrogen (OR, 1.05; 95% CI, 1.02-1.07, P < .001), creatinine (OR, 0.30; 95% CI, 0.15-0.60, P = .001), K (OR, 1.98; 95% CI, 1.14-3.46, P = .015), and platelet (OR, 0.996; 95% CI, 0.993-0.999, P = .006) were independent risk factors for mortality.

CONCLUSION

In light of the results of our study, we believe that sepsis cases and mortality can be prevented through widespread quality improvement programs such as shortening the duration of mechanical ventilation in postoperative surgical patients, effective treatment of some metabolic, electrolyte and coagulation disorders during intensive care stay, and regulation of blood product and colloid use.