No abstract available.
Mortality* ; Rhinoplasty* ; Sepsis* ; Transplants*

Introduction: The Third International Consensus Definitions for Sepsis and Septic Shock in 2016 promoted the new definition and prognostication scheme among patients with sepsis using the Sequential Organ Failure Assessment (SOFA) scoring system. This study determined the discriminative power of the second-day SOFA scoring system in predicting 30-day hospital mortality among adult Filipino patients who presented with sepsis in a tertiary government hospital in the urban setting in the Philippines. Methods: We evaluated 107 adult with sepsis presenting at the emergency department from June 1, 2017 to August 31, 2017 in a 300 bed capacity tertiary hospital. Receiving operating characteristic curves were generated to determine optimal cut off scores of the SOFA scoring system in predicting 30-day mortality. Binary logistic regression was performed to determine the association of the SOFA derivatives with hospital mortality. STATA 15 was used for data analysis. Results: Second-day SOFA scores had excellent predictive ability for 30-day mortality at a cutoff point of 5, with sensitivity and specificity at 84.21% and 84.81%, respectively as compared with other SOFA derivatives at a given point in time. Conclusion The utility of second-day SOFA Score at a lower cut off score of five, has s a good discriminative power in predicting the all cause mortality among adult septic patients. This lower cut off score indicated a lower threshold trigger in identifying patients needing more intensive monitoring given the association of higher mortality risk in comparison with other studies done abroad.
Sepsis ; Mortality ; Philippines

Background: The quick Sequential Organ Failure Assessment (qSOFA) score was introduced by Sepsis-3 or the Third International Consensus Definitions for Sepsis and Septic Shock to help physicians in identifying patients outside the intensive care unit with suspected infection who are at high risk for in-hospital mortality. However, sepsis is not a homogenous entity and the outcomes vary based on several factors. This study aimed to determine the predictive accuracy of qSOFA in identifying those at high-risk of in-hospital mortality among adult patients with sepsis secondary to urinary tract infection. Methodology: A retrospective cohort study was done involving the use of qSOFA score to predict in-hospital mortality of adult patients with a diagnosis of sepsis secondary to urinary tract infection, admitted in the hospital from January 1, 2013 to December 31, 2020. qSOFA is computed based on the following independent variables: systolic blood pressure (SBP), respiratory rate (RR), and Glasgow Coma Scale (GCS). Results: Of the 128 charts retrieved, 121 patients were included in the study. Fifteen (12.40%) died while 106 (87.60%) survived. Mean age was 60.76 years old, with more females (71.90%) than males (28.10%). Hypertension and Diabetes Mellitus Type 2 were the most frequent comorbidities. Complicated UTI was the most frequent source of infection. Mean length of stay was 8.29 days. Forty (33.06%) patients had qSOFA ≥ 2 wherein 11 (27.5%) died. Diagnostic performance results revealed: sensitivity (73.33%), specificity (72.64%), positive (27.5%) and negative (95.06%) predictive values, and positive (2.68) and negative (0.37) likelihood ratios. qSOFA accuracy was 72.73% with an AUROC of 0.76. Conclusion Among the admitted adult patients with sepsis secondary to a UTI, qSOFA had a good prognostic accuracy for in-hospital mortality.
Sepsis ; Urinary Tract Infections ; Hospital Mortality

Boerhaave's syndrome is a rare spontaneous rupture of the esophagus that requires an immediate diagnosis and surgical repair. It might result from a severe and uncoordinated contraction of the esophagus and stomach. The rate of mortality and morbidity can increase with increasing time between the onset and treatment. In recent years, there have been some reports of non-surgical treatment in cases with perforation but with minimal symptoms and clinical evidence of the systemic effects such as sepsis. We experienced a case of Boerhaave's syndrome occurring during an endoscopic examination that was treated successfully using non-surgical measures.
Diagnosis ; Endoscopy* ; Esophagus ; Mortality ; Rupture, Spontaneous ; Sepsis ; Stomach

Neonatal sepsis is a major contributing factor for increased mortality and morbidity in the newbron and its successful outcome depends on early detection and prompt institution of an effective antimic robial therapy. Accurate diagnosis of the neonatal septicemia, however, is quite difficult because its early signs and symptoms are rather subtle. This study was conducted in an attempt to search for useful early markers for the clinical entity A total of 224 newborns, over a 17 month pcriod (1/90 5/91), who were evaluated for probable neonatal sepsis were analysed. The laboratory parameters that showed highest correlation with bacteriologically proves sopsis were as follows: Total WBC counts (<5,000/mm), Band/Total ncutrophils(>0.2), elevated ESR(>15mm/hr), CRP(>6ng/ml). Of the 224 study subjects, 41 had two or more parameters of which 12 subjects had positive blood cultures(positive predictive value:29%), only 4 of the 183 newborns who had less than 2 parameters had positive blood cultures(false negative:2%). It is concluded that the presence of two or more of the above parameters can be used as a strong indicator for neonatal sepsis and its sensitivity is 75% while specificity is 86%.
Diagnosis ; Early Diagnosis* ; Humans ; Infant, Newborn ; Mortality ; Sensitivity and Specificity ; Sepsis*

BACKGROUND: Vibrio vulnificus sepsis requires a rapid and accurate bacteriological diagnosis for optimal management of the patient because of its high mortality. We evaluated two automated bacteriological identification systems, Microscan (WalkAway 96, Dade Behring, West Sacramento, CA, USA) and Vitek II (bioMerieux, Durham, NC, USA), for their ability to identify V. vulnificus strains isolated from clinical specimens. METHODS: A total of 60 V. vulnificus strains isolated from clinical specimens in Chonnam University Hospital during 1993-2003 were tested. For the identification of the isolates by the Microscan, Neg Combo type 32 was used and four different panel inoculation methods were evaluated for accuracy. Identification by the Vitek II system was carried out using Vitek ID-GNB cards in accordance with the manufacturers, instruction using 0.45% saline media. RESULTS: With the Microscan, the most accurate identification result was obtained after a modified inoculation method of the panel with a bacterial suspension prepared in 0.85% saline; the identification rate was 100%. The identification rate of Vitek II system was 96.7%; two strains of V. vulnificus were misidentified as V. harveyi and V. alginolyticus. CONCLUSIONS: These results indicate that both Microscan and Vitek II are adequate for the identification of clinical isolates of V. vulnificus, but for the identification by the Microscan a modified inoculation method should be used by suspending the organisms in 0.85% saline.
Diagnosis ; Humans ; Jeollanam-do ; Mortality ; Sepsis ; Vibrio vulnificus*

The management of chronic empyema remains still disturbing. These patients always have chances to exposure septic conditions. We presents 4 patients of chronic empyema with sepsis who underwent E-flap and Myoplasty with extrathoracic skeletal muscles between December 1994 and March 1997. Two patients who had BPF were treated with intercostal muscle flap as co-procedures. Intervals between first E-flap and second Myoplasty ranged from 5 to 10 months. There was no morbidity or mortality. We think these stepwise procedure offers a chance to terminate these debilitating disease.
Empyema* ; Humans ; Intercostal Muscles ; Mortality ; Muscle, Skeletal ; Sepsis*

No abstract available.
Intensive Care Units ; Sepsis ; Critical Illness ; Chronic Disease ; Hospital Mortality

Humans ; Hydroxyethyl Starch Derivatives ; therapeutic use ; Sepsis ; mortality ; therapy

Humans ; Hydroxyethyl Starch Derivatives ; therapeutic use ; Sepsis ; mortality ; therapy