Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study

Detalhes bibliográficos
Autor(a) principal: Gonçalves, Bruno
Data de Publicação: 2019
Outros Autores: Kurtz, Pedro, Turon, Ricardo, Santos, Thayana, Prazeres, Marco, Righy, Cassia, Bozza, Fernando Augusto
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/35501
Resumo: Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil.
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spelling Gonçalves, BrunoKurtz, PedroTuron, RicardoSantos, ThayanaPrazeres, MarcoRighy, CassiaBozza, Fernando Augusto2019-09-11T15:07:03Z2019-09-11T15:07:03Z2019GONÇALVES, Bruno et al. Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study. Annals of Intensive Care, v. 9, p. 1-8, 2019.2110-5820https://www.arca.fiocruz.br/handle/icict/3550110.1186/s13613-019-0562-32110-5820engBMCIncidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleInstituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil.Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil.Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.Background: Aneurysmal subarachnoid hemorrhage (SAH) is an acute cerebrovascular disease associated with high mortality and long-term functional impairment among survivors. Systemic infammatory responses after acute injury and nosocomial infections are frequent complications, making the management of these patients challenging. Here, we hypothesized that sepsis might be associated with early and long-term mortality and functional outcomes. Our objective was to defne the incidence of sepsis, diagnosed prospectively with the Sepsis-3 criteria, and to determine its impact on mortality and functional outcomes of patients with SAH. Methods: We prospectively included all adult patients with aneurysmal SAH admitted to the intensive care unit (ICU) of a reference center between April 2016 and May 2018. Daily clinical and laboratory follow-up data were analyzed during the frst 14 days, with data collected on sepsis according to the Sepsis-3 criteria. The main outcome was the functional outcome using the Modifed Rankin Scale (mRS), which was assessed at hospital discharge and 3, 6 and 12 months post-discharge. Results: In total, 149 patients were enrolled. The incidence of sepsis was 28%. Multivariable logistic regression analysis revealed that death or functional dependence (defned as an mRS score of 4 to 6) at hospital discharge was independently associated with sepsis (OR 3.4, 95% CI 1.16–9.96, p=0.026) even after controlling for World Federation of Neurological Surgeons (WFNS) Scale (OR 4.66, 95% CI 1.69–12.88, p=0.003), hydrocephalus (OR 4.55, 95% CI 1.61–12.85, p=0.004) and DCI (OR 3.86, 95% CI 1.39–10.74, p=0.01). Long-term follow-up mortality rates were signifcantly diferent in the septic and nonseptic groups (log-rank test p<0.0001). The mortality rate of septic patients was 52.5%, and that of nonseptic patients was 16%. Conclusion: Sepsis plays a signifcant role in the outcomes of patients with SAH, afecting both mortality and longterm functional outcomes. Combining high-level neurocritical care management of neurological complications and the optimal diagnosis and management of sepsis may efectively reduce secondary brain injury and improve patients’ outcomes after SAH.Subarachnoid hemorrhageSepsisInfectionCritical care outcomesinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-83104https://www.arca.fiocruz.br/bitstream/icict/35501/1/license.txt79178e5f2a0eb066867a274556814938MD51ORIGINALve_Gonçalves_Bruno_etal_INI_2019.pdfve_Gonçalves_Bruno_etal_INI_2019.pdfapplication/pdf959483https://www.arca.fiocruz.br/bitstream/icict/35501/2/ve_Gon%c3%a7alves_Bruno_etal_INI_2019.pdf25fc56df721d0f0d9e5ae0a068bfc9f2MD52TEXTve_Gonçalves_Bruno_etal_INI_2019.pdf.txtve_Gonçalves_Bruno_etal_INI_2019.pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
title Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
spellingShingle Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
Gonçalves, Bruno
Subarachnoid hemorrhage
Sepsis
Infection
Critical care outcomes
title_short Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
title_full Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
title_fullStr Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
title_full_unstemmed Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
title_sort Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study
author Gonçalves, Bruno
author_facet Gonçalves, Bruno
Kurtz, Pedro
Turon, Ricardo
Santos, Thayana
Prazeres, Marco
Righy, Cassia
Bozza, Fernando Augusto
author_role author
author2 Kurtz, Pedro
Turon, Ricardo
Santos, Thayana
Prazeres, Marco
Righy, Cassia
Bozza, Fernando Augusto
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Gonçalves, Bruno
Kurtz, Pedro
Turon, Ricardo
Santos, Thayana
Prazeres, Marco
Righy, Cassia
Bozza, Fernando Augusto
dc.subject.en.pt_BR.fl_str_mv Subarachnoid hemorrhage
Sepsis
Infection
Critical care outcomes
topic Subarachnoid hemorrhage
Sepsis
Infection
Critical care outcomes
description Instituto Estadual do Cérebro Paulo Niemeyer. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Medicina Intensiva. Rio de Janeiro, RJ, Brasil.
publishDate 2019
dc.date.accessioned.fl_str_mv 2019-09-11T15:07:03Z
dc.date.available.fl_str_mv 2019-09-11T15:07:03Z
dc.date.issued.fl_str_mv 2019
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv GONÇALVES, Bruno et al. Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study. Annals of Intensive Care, v. 9, p. 1-8, 2019.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/35501
dc.identifier.issn.pt_BR.fl_str_mv 2110-5820
dc.identifier.doi.none.fl_str_mv 10.1186/s13613-019-0562-3
dc.identifier.eissn.none.fl_str_mv 2110-5820
identifier_str_mv GONÇALVES, Bruno et al. Incidence and impact of sepsis on long-term outcomes after subarachnoid hemorrhage: a prospective observational study. Annals of Intensive Care, v. 9, p. 1-8, 2019.
2110-5820
10.1186/s13613-019-0562-3
url https://www.arca.fiocruz.br/handle/icict/35501
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Repositório Institucional da FIOCRUZ (ARCA)
collection Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/35501/1/license.txt
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repository.name.fl_str_mv Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)
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