Attributable mortality due to nosocomial sepsis in Brazilian hospitals: a case-control study.
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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 |
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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 |
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http://hdl.handle.net/11690/3741 |
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eng |
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Springer |
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Springer |
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