Impact of oncologic pathology (OP) in the evolution of severe sepsis (SS) in the critically ill patients (CIP)

Abstract

Issue Title: ESICM LIVES 2015

Ruiz Moreno et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A247

http://www.icm-experimental.com/content/3/S1/A247

POSTER PRESENTATION Open Access

Impact of oncologic pathology (OP) in the evolution of severe sepsis (SS) in the critically ill patients (CIP)

J Ruiz Moreno1*, E Gonzlez Marn1, MJ Esteve Paos1, R Corcuera Romero de la Devesa1, M Moral Guiteras1, M Juli Amill1, N Surez lvarez1, N Conesa Folch1, F Baigorri Gonzlez1, A Artigas Ravents2

From ESICM LIVES 2015Berlin, Germany. 3-7 October 2015

Intr

It is considered that the severity of septic CIPs is higher than the overall CIPs requiring ICU admission. Nevertheless, the impact of the OP over the severity of the SS perhaps has not been sufficiently analyzed and evaluated.

Objectives

To evaluate the impact of the OP in the evolution of the SS of the CIPs.

Methods

Study: prospective, analytical, longitudinal, and observational Period: January 1-2011 / June 30-2014 (42 months) SETTING. Medical/Surgical ICU Population: 2559 CIPs admitted consecutively to the ICU; sample: 484 CIPs with SS.

Exclusin criteria: CIPs < 16 y., major burn CIPs, incomplete clinical documentation, and voluntary discharge. Variables analyzed:a) Ageb) Hospital mortalityc) Case - mix: metabolic acidosis, total parenteral nutrition, intra-abdominal pressure (IAP), blood products, cultures, cardiac output, renal replacement therapy (RRT), advanced life support (ALS), FGC, FBC,e) Organ dysfunction: SOFA and LODSf) Limitation of life support (LLS). Statistical analysis: Ji squared and contrast of means (Students t) Limitations of the study: absence of critically burned patients and pediatric CIPs

Table 1

Global % SS % SS with OP % SS witout OP % p value N 2559 100 484 18,9 130 26,9 354 73,1Age 65,88 16,7 73,5 13,1 73,18 11,4 73,64 13,7 NS Mortality 182 7,1 120 24,8 39 30,0 81 22,9 NSRRT 91 3,6 70 14,6 20 15,8 50 14,1 NSTPN 467 18,2 184 38,0 90 69,3 94 26,5 0,0001 IAP 136 5,3 101 20,8 37 28,6 64 18,1 0,012 Metb acid 955 37,3 368 76,0 113 86,9113 255 72,0 0,0006

1QuirnSalud Hospital Universitario Sagrat Cor, Critical Care Department, Barcelona, SpainFull list of author information is available at the end of the article

2015 Ruiz Moreno et al.; This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0

Web End =http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ruiz Moreno et al. Intensive Care Medicine Experimental 2015, 3(Suppl 1):A247

http://www.icm-experimental.com/content/3/S1/A247

Page 2 of 2

Table 2

Global % SS % SS with OP % SS witout OP % p value Blood products 500 19,5 216 44,6 83 63,8 133 37,6 0,0001 NS NS Cultures 689 26,9 456 94,2 119 91,5 337 95,2 NS Pericardiocent. 8 0,3 3 0,6 2 1,5 1 0,9 NSALS 85 3,3 42 8,7 16 12,3 26 7,3 0,085FGC 54 2,1 28 5,8 8 6,1 20 5,6 NSFBC 61 2,3 47 9,7 12 9,2 35 9,9 NSLLS 220 8,6 122 25,2 41 31,5 81 22,9 0,0518

Results

Global CIPs: 2559; sepsis CIPs: 484; non sepsis CIPs: 2075

SOFA: Global (2.70), septic CIPs (5,32), non-septic CIPs (1,90)

LODS: Global (1.37), septic CIPs (2,78), non-septic CIPs (0,94)

See Tables 1 and 2.

Conclusions

1) The OP conditions not age or mortality of CIPs with SS.2) Metabolic acidosis and the need of TPN, IAP and blood products are higher in the SS with OP.3) Cultures, RRT, ALS, FGC, and FBC are applied equally in both groups.4) The LLS is applied more in the SS with OP.

Authors details

1QuirnSalud Hospital Universitario Sagrat Cor, Critical Care Department, Barcelona, Spain. 2Hospital de Clnicas de Sabadell & QuirnSalud Hospital Universitario Sagrat Cor, Critical Care Department, Sabadell, Spain.

Published: 1 October 2015

References1. Phillips R, Hancock B, Graham J, Bromham N, Jin H, Berendse S: Prevention and management of neutropenic sepsis in patients with cancer: summary of NICE guidance. BMJ 2012, 345:e5368.

2. Corcuera Romero de la Devesa R, Ruiz Moreno J, Gonzlez Marn E, Esteve Paos MJ, Godayol Arias S, Conesa Folch N, Rinaudo Videla M, Artigas Ravents A: Evaluation of severity in critically ill patientes (CIPS) with sepsis. European Society of Intensive Care Medicine, 27th Annual Congres Barcelona, Spain; 2014, September.

3. Kaukonen KM, Bailey M, Suzuki S, Pilcher D, Bellomo R: Mortality Related to Severe Sepsis and Septic Shock Among Critically Ill Patients in Australia and New Zealand, 2000-2012. JAMA 2014, 311(13):1308-1316.

doi:10.1186/2197-425X-3-S1-A247Cite this article as: Ruiz Moreno et al.: Impact of oncologic pathology (OP) in the evolution of severe sepsis (SS) in the critically ill patients (CIP). Intensive Care Medicine Experimental 2015 3(Suppl 1):A247.

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