Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.

Detalhes bibliográficos
Autor(a) principal: Zampieri, Fernando G.
Data de Publicação: 2023
Outros Autores: Cavalcanti, Alexandre B., Taniguchi, Leandro U., Lisboa, Thiago C., Serpa‑Neto, Ary, Azevedo, Luciano C. P., Nassar Jr, Antonio Paulo, Miranda, Tamiris A., Gomes, Samara P. C., Alencar Filho, Meton S. de, Silva, Rodrigo T. Amancio da, Lacerda, Fabio Holanda, Veiga, Viviane Cordeiro, Manoel, Airton Leonardo de Oliveira, Biondi, Rodrigo S., Maia, Israel S., Lovato, Wilson J., Oliveira, Claudio Dornas de, Pizzol, Felipe Dal, Caldeira Filho, Milton, Amendola, Cristina P., Westphal, Glauco A., Figueiredo, Rodrigo C., Caser, Eliana B., Figueiredo, Lanese M. de, Freitas, Flávio Geraldo R. de, Fernandes, Sergio S., Gobatto, Andre Luiz N., Paranhos, Jorge Luiz R., Melo, Rodrigo Morel V. de, Sousa, Michelle T., Almeida, Guacyra Margarita B. de, Ferronatto, Bianca R., Ferreira, Denise M., Ramos, Fernando J. S., Thompson, Marlus M., Grion, Cintia M. C., Santos, Renato Hideo Nakagawa, Damiani, Lucas P., Machado, Flavia R.
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional do Centro Universitário La Salle
Texto Completo: http://hdl.handle.net/11690/3741
Resumo: Background Nosocomial sepsis is a major healthcare issue, but there are few data on estimates of its attributable mortality. We aimed to estimate attributable mortality fraction (AF) due to nosocomial sepsis. Methods Matched 1:1 case–control study in 37 hospitals in Brazil. Hospitalized patients in participating hospitals were included. Cases were hospital non-survivors and controls were hospital survivors, which were matched by admission type and date of discharge. Exposure was defned as occurrence of nosocomial sepsis, defned as antibiotic prescription plus presence of organ dysfunction attributed to sepsis without an alternative reason for organ failure; alternative defnitions were explored. Main outcome measurement was nosocomial sepsis-attributable fractions, esti‑ mated using inversed-weight probabilities methods using generalized mixed model considering time-dependency of sepsis occurrence. Results 3588 patients from 37 hospitals were included. Mean age was 63 years and 48.8% were female at birth. 470 sepsis episodes occurred in 388 patients (311 in cases and 77 in control group), with pneumonia being the most common source of infection (44.3%). Average AF for sepsis mortality was 0.076 (95% CI 0.068–0.084) for medical admissions; 0.043 (95% CI 0.032–0.055) for elective surgical admissions; and 0.036 (95% CI 0.017–0.055) for emergency surgeries. In a time-dependent analysis, AF for sepsis rose linearly for medical admissions, reaching close to 0.12 on day 28; AF plateaued earlier for other admission types (0.04 for elective surgery and 0.07 for urgent surgery). Alterna‑ tive sepsis defnitions yield diferent estimates.Conclusion The impact of nosocomial sepsis on outcome is more pronounced in medical admissions and tends to increase over time. The results, however, are sensitive to sepsis defnitions
id UNILASALLE_a55ac0d0653ed595fc7852d9b6256a20
oai_identifier_str oai:svr-net20.unilasalle.edu.br:11690/3741
network_acronym_str UNILASALLE
network_name_str Repositório Institucional do Centro Universitário La Salle
repository_id_str https://dspace.unilasalle.edu.br/
spelling Zampieri, Fernando G.Cavalcanti, Alexandre B.Taniguchi, Leandro U.Lisboa, Thiago C.Serpa‑Neto, AryAzevedo, Luciano C. P.Nassar Jr, Antonio PauloMiranda, Tamiris A.Gomes, Samara P. C.Alencar Filho, Meton S. deSilva, Rodrigo T. Amancio daLacerda, Fabio HolandaVeiga, Viviane CordeiroManoel, Airton Leonardo de OliveiraBiondi, Rodrigo S.Maia, Israel S.Lovato, Wilson J.Oliveira, Claudio Dornas dePizzol, Felipe DalCaldeira Filho, MiltonAmendola, Cristina P.Westphal, Glauco A.Figueiredo, Rodrigo C.Caser, Eliana B.Figueiredo, Lanese M. deFreitas, Flávio Geraldo R. deFernandes, Sergio S.Gobatto, Andre Luiz N.Paranhos, Jorge Luiz R.Melo, Rodrigo Morel V. deSousa, Michelle T.Almeida, Guacyra Margarita B. deFerronatto, Bianca R.Ferreira, Denise M.Ramos, Fernando J. S.Thompson, Marlus M.Grion, Cintia M. C.Santos, Renato Hideo NakagawaDamiani, Lucas P.Machado, Flavia R.2023-11-20T17:19:12Z2023-11-20T17:19:12Z2023LISBOA, T. C. et al. Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study. Annals of Intensive Care, v. 13, p. 32, 2023. Disponível em: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01123-y. Acesso em: 17 nov. 2023http://hdl.handle.net/11690/3741Background Nosocomial sepsis is a major healthcare issue, but there are few data on estimates of its attributable mortality. We aimed to estimate attributable mortality fraction (AF) due to nosocomial sepsis. Methods Matched 1:1 case–control study in 37 hospitals in Brazil. Hospitalized patients in participating hospitals were included. Cases were hospital non-survivors and controls were hospital survivors, which were matched by admission type and date of discharge. Exposure was defned as occurrence of nosocomial sepsis, defned as antibiotic prescription plus presence of organ dysfunction attributed to sepsis without an alternative reason for organ failure; alternative defnitions were explored. Main outcome measurement was nosocomial sepsis-attributable fractions, esti‑ mated using inversed-weight probabilities methods using generalized mixed model considering time-dependency of sepsis occurrence. Results 3588 patients from 37 hospitals were included. Mean age was 63 years and 48.8% were female at birth. 470 sepsis episodes occurred in 388 patients (311 in cases and 77 in control group), with pneumonia being the most common source of infection (44.3%). Average AF for sepsis mortality was 0.076 (95% CI 0.068–0.084) for medical admissions; 0.043 (95% CI 0.032–0.055) for elective surgical admissions; and 0.036 (95% CI 0.017–0.055) for emergency surgeries. In a time-dependent analysis, AF for sepsis rose linearly for medical admissions, reaching close to 0.12 on day 28; AF plateaued earlier for other admission types (0.04 for elective surgery and 0.07 for urgent surgery). Alterna‑ tive sepsis defnitions yield diferent estimates.Conclusion The impact of nosocomial sepsis on outcome is more pronounced in medical admissions and tends to increase over time. The results, however, are sensitive to sepsis defnitionsSpringerSepsisAttributable mortalityEpidemiologyAttributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessengreponame:Repositório Institucional do Centro Universitário La Salleinstname:Universidade La Salle (UNILASALLE)instacron:UNILASALLEORIGINALtclisboa.pdftclisboa.pdfOpen Accessapplication/pdf950405http://svr-net20.unilasalle.edu.br/bitstream/11690/3741/1/tclisboa.pdf573fb25224a33640727877b160c32d29MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-81748http://svr-net20.unilasalle.edu.br/bitstream/11690/3741/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD5211690/37412023-11-20 14:20:01.046oai:svr-net20.unilasalle.edu.br: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Repositório Institucionalopendoar:2023-11-20T17:20:01Repositório Institucional do Centro Universitário La Salle - Universidade La Salle (UNILASALLE)false
dc.title.pt_BR.fl_str_mv Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
title Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
spellingShingle Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
Zampieri, Fernando G.
Sepsis
Attributable mortality
Epidemiology
title_short Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
title_full Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
title_fullStr Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
title_full_unstemmed Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
title_sort Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
author Zampieri, Fernando G.
author_facet Zampieri, Fernando G.
Cavalcanti, Alexandre B.
Taniguchi, Leandro U.
Lisboa, Thiago C.
Serpa‑Neto, Ary
Azevedo, Luciano C. P.
Nassar Jr, Antonio Paulo
Miranda, Tamiris A.
Gomes, Samara P. C.
Alencar Filho, Meton S. de
Silva, Rodrigo T. Amancio da
Lacerda, Fabio Holanda
Veiga, Viviane Cordeiro
Manoel, Airton Leonardo de Oliveira
Biondi, Rodrigo S.
Maia, Israel S.
Lovato, Wilson J.
Oliveira, Claudio Dornas de
Pizzol, Felipe Dal
Caldeira Filho, Milton
Amendola, Cristina P.
Westphal, Glauco A.
Figueiredo, Rodrigo C.
Caser, Eliana B.
Figueiredo, Lanese M. de
Freitas, Flávio Geraldo R. de
Fernandes, Sergio S.
Gobatto, Andre Luiz N.
Paranhos, Jorge Luiz R.
Melo, Rodrigo Morel V. de
Sousa, Michelle T.
Almeida, Guacyra Margarita B. de
Ferronatto, Bianca R.
Ferreira, Denise M.
Ramos, Fernando J. S.
Thompson, Marlus M.
Grion, Cintia M. C.
Santos, Renato Hideo Nakagawa
Damiani, Lucas P.
Machado, Flavia R.
author_role author
author2 Cavalcanti, Alexandre B.
Taniguchi, Leandro U.
Lisboa, Thiago C.
Serpa‑Neto, Ary
Azevedo, Luciano C. P.
Nassar Jr, Antonio Paulo
Miranda, Tamiris A.
Gomes, Samara P. C.
Alencar Filho, Meton S. de
Silva, Rodrigo T. Amancio da
Lacerda, Fabio Holanda
Veiga, Viviane Cordeiro
Manoel, Airton Leonardo de Oliveira
Biondi, Rodrigo S.
Maia, Israel S.
Lovato, Wilson J.
Oliveira, Claudio Dornas de
Pizzol, Felipe Dal
Caldeira Filho, Milton
Amendola, Cristina P.
Westphal, Glauco A.
Figueiredo, Rodrigo C.
Caser, Eliana B.
Figueiredo, Lanese M. de
Freitas, Flávio Geraldo R. de
Fernandes, Sergio S.
Gobatto, Andre Luiz N.
Paranhos, Jorge Luiz R.
Melo, Rodrigo Morel V. de
Sousa, Michelle T.
Almeida, Guacyra Margarita B. de
Ferronatto, Bianca R.
Ferreira, Denise M.
Ramos, Fernando J. S.
Thompson, Marlus M.
Grion, Cintia M. C.
Santos, Renato Hideo Nakagawa
Damiani, Lucas P.
Machado, Flavia R.
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Zampieri, Fernando G.
Cavalcanti, Alexandre B.
Taniguchi, Leandro U.
Lisboa, Thiago C.
Serpa‑Neto, Ary
Azevedo, Luciano C. P.
Nassar Jr, Antonio Paulo
Miranda, Tamiris A.
Gomes, Samara P. C.
Alencar Filho, Meton S. de
Silva, Rodrigo T. Amancio da
Lacerda, Fabio Holanda
Veiga, Viviane Cordeiro
Manoel, Airton Leonardo de Oliveira
Biondi, Rodrigo S.
Maia, Israel S.
Lovato, Wilson J.
Oliveira, Claudio Dornas de
Pizzol, Felipe Dal
Caldeira Filho, Milton
Amendola, Cristina P.
Westphal, Glauco A.
Figueiredo, Rodrigo C.
Caser, Eliana B.
Figueiredo, Lanese M. de
Freitas, Flávio Geraldo R. de
Fernandes, Sergio S.
Gobatto, Andre Luiz N.
Paranhos, Jorge Luiz R.
Melo, Rodrigo Morel V. de
Sousa, Michelle T.
Almeida, Guacyra Margarita B. de
Ferronatto, Bianca R.
Ferreira, Denise M.
Ramos, Fernando J. S.
Thompson, Marlus M.
Grion, Cintia M. C.
Santos, Renato Hideo Nakagawa
Damiani, Lucas P.
Machado, Flavia R.
dc.subject.por.fl_str_mv Sepsis
Attributable mortality
Epidemiology
topic Sepsis
Attributable mortality
Epidemiology
description Background Nosocomial sepsis is a major healthcare issue, but there are few data on estimates of its attributable mortality. We aimed to estimate attributable mortality fraction (AF) due to nosocomial sepsis. Methods Matched 1:1 case–control study in 37 hospitals in Brazil. Hospitalized patients in participating hospitals were included. Cases were hospital non-survivors and controls were hospital survivors, which were matched by admission type and date of discharge. Exposure was defned as occurrence of nosocomial sepsis, defned as antibiotic prescription plus presence of organ dysfunction attributed to sepsis without an alternative reason for organ failure; alternative defnitions were explored. Main outcome measurement was nosocomial sepsis-attributable fractions, esti‑ mated using inversed-weight probabilities methods using generalized mixed model considering time-dependency of sepsis occurrence. Results 3588 patients from 37 hospitals were included. Mean age was 63 years and 48.8% were female at birth. 470 sepsis episodes occurred in 388 patients (311 in cases and 77 in control group), with pneumonia being the most common source of infection (44.3%). Average AF for sepsis mortality was 0.076 (95% CI 0.068–0.084) for medical admissions; 0.043 (95% CI 0.032–0.055) for elective surgical admissions; and 0.036 (95% CI 0.017–0.055) for emergency surgeries. In a time-dependent analysis, AF for sepsis rose linearly for medical admissions, reaching close to 0.12 on day 28; AF plateaued earlier for other admission types (0.04 for elective surgery and 0.07 for urgent surgery). Alterna‑ tive sepsis defnitions yield diferent estimates.Conclusion The impact of nosocomial sepsis on outcome is more pronounced in medical admissions and tends to increase over time. The results, however, are sensitive to sepsis defnitions
publishDate 2023
dc.date.accessioned.fl_str_mv 2023-11-20T17:19:12Z
dc.date.available.fl_str_mv 2023-11-20T17:19:12Z
dc.date.issued.fl_str_mv 2023
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 LISBOA, T. C. et al. Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study. Annals of Intensive Care, v. 13, p. 32, 2023. Disponível em: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01123-y. Acesso em: 17 nov. 2023
dc.identifier.uri.fl_str_mv http://hdl.handle.net/11690/3741
identifier_str_mv LISBOA, T. C. et al. Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study. Annals of Intensive Care, v. 13, p. 32, 2023. Disponível em: https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-023-01123-y. Acesso em: 17 nov. 2023
url http://hdl.handle.net/11690/3741
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 Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Repositório Institucional do Centro Universitário La Salle
instname:Universidade La Salle (UNILASALLE)
instacron:UNILASALLE
instname_str Universidade La Salle (UNILASALLE)
instacron_str UNILASALLE
institution UNILASALLE
reponame_str Repositório Institucional do Centro Universitário La Salle
collection Repositório Institucional do Centro Universitário La Salle
bitstream.url.fl_str_mv http://svr-net20.unilasalle.edu.br/bitstream/11690/3741/1/tclisboa.pdf
http://svr-net20.unilasalle.edu.br/bitstream/11690/3741/2/license.txt
bitstream.checksum.fl_str_mv 573fb25224a33640727877b160c32d29
8a4605be74aa9ea9d79846c1fba20a33
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
repository.name.fl_str_mv Repositório Institucional do Centro Universitário La Salle - Universidade La Salle (UNILASALLE)
repository.mail.fl_str_mv
_version_ 1808846740004012032