Importance of Source Control in the Subgroup of Intra-Abdominal Infections for Septic Shock Patients: Analysis of 390 Cases
Makaleler > Tam Makale · 2024
Yazarlar: Ugur Onal, Deniz Akyol Seyhan, Olcay Buse Ketenoglu, Merve Mert Vahabi, Dilsah Baskol Elik, Seichan Chousein Memetali, Gamze Sanlidag Isbilen, Cansu Bulut Avsar, Arda Kaya, Oğuz Reşat SİPAHİ, Nazlihan Yalcin, Guenel Guliyeva, Sukrue Dirik, Oguzhan Acet, Damla Akdag, Melike Demir Gorur, Osman BOZBIYIK, Berk Goktepe, Tufan Gumus, Ilkin Cankayali, Kubilay Demirag, Mehmet Uyar, Hilal Sipahi, Hüseyin Aytaç ERDEM, Meltem Iikgoz Tabakan, Bilgin Arda, Soehret Aydemir, Sercan Ulusoy, Oğuz Reşat SİPAHİ
MEDITERRANEAN JOURNAL OF HEMATOLOGY AND INFECTIOUS DISEASES, SCI İndekslerine Giren Dergi, Uluslararası, Wos, 2024, cilt 16, ss e2024051-e2024051
Özet
Background: This study aimed to evaluate the epidemiology of septic shock (SS) associated with intraabdominal infections (IAI) as well as associated mortality and efficacy of early source control in a tertiary -care educational hospital. Methods: Patients who had SS with IAI and consulted by Infectious Diseases consultants between December 2013 and October 2022 during night shifts in our centre were analyzed retrospectively. Results: A total number of 390 patients were included. Overall, 30 -day mortality was 42.5% on day 3, while day 14 and 30 mortality rates were 63.3% and 71.3%, respectively. Source control by surgical or percutaneous operation was performed in 123 of 390 cases (31.5%), and the mortality rate was significantly lower in cases that were performed source control at any time during SS (65/123-52.8% vs 213/267-79.8%, p<0.001). In 44 of 123 cases (35.7%), source control was performed during the first 12 hours, and mortality was significantly lower in this group versus others (24/44-54.5% vs 254/346-73.4%, p=0.009). On the other hand, female gender (p<0.001, odds ratio(OR)= 2.943, 95%CI=1.714-5.054), diabetes mellitus (p= 0.014, OR=2.284, 95%CI=1.1794.424), carbapenem-resistant Gram-negative etiology (p=0.011, OR=4.386, 95%CI=1.398-13.759), SOFA >= 10 (p<0.001, OR=3.036, 95%CI=1.802 -5.114), lactate >3 mg/dl (p<0.001, OR=2.764, 95%CI=1.562-4.891) and lack of source control (p=0.001, OR=2.796, 95%CI=1.523-5.133) were significantly associated with 30 -day mortality in logistic regression analysis. Conclusion: Source control has a vital importance in terms of mortality rates for IAI-related septic shock patients. Our study underscores the need for additional research, as the present analysis indicates that early source control does not manifest as a protective factor in logistic regression.