| Abstract | Ciljevi: Prezentirati i usporediti učestalost dijagnoze sepse, kliničke, mikrobiološke i terapijske
karakteristike bolesnika sa sepsom hospitaliziranih 2017. i 2022. godine.
Materijali i metode: U istraživanje je uključeno 266 bolesnika s dijagnozom sepse liječenih u
Klinici za infektologiju KBC-a Split 2017. i 2022. godine. Istraživanje je po organizaciji
retrospektivna studija provedena uvidom u medicinsku dokumentaciju bolesnika.
Rezultati: Medijan dobi hospitaliziranih zbog sepse je 2017. i 2022. godine bio 75 godina.
Žene su činile 60% hospitaliziranih bolesnika sa sepsom 2017. godine, dok su muškarci činili
54.8% hospitaliziranih bolesnika sa sepsom 2022. godine. Najčešći kronični, predispozicijski
čimbenik za razvoj sepse je 2017. (60%) i 2022. (74%) godine bila bolest kardiovaskularnog
sustava. Najčešći uzročnici su 2017. godine bili gram-negativni osjetljivi bacili (53.3%), dok
su 2022. godine hemokulture u najvećem broju slučajeva bile negativne (45.2%). Najčešće
ishodište sepse je 2017. (61.7%) i 2022. (34.9%) godine bio mokraćni sustav. Bolesnici su 2017.
godine u 35% slučajeva liječeni kombinacijom antibiotika prve linije i rezervnog antibiotika,
odnosno u 35% slučajeva samo rezervnim antibiotikom. U 2022. godini je 37.7% bolesnika sa
sepsom liječeno kombinacijom antibiotika prve linije i rezervnog antibiotika. Medijan trajanja
hospitalizacije bolesnika s dijagnozom sepse je 2017. godine iznosio 12 dana, a 2022. godine 6
dana. Najčešći ishod obje godine je bio povoljan, odnosno 70% bolesnika sa sepsom je
preživjelo 2017. godine, dok ih je 52.7% preživjelo 2022. godine.
Zaključci: Od sindroma sepse najčešće oboljevaju osobe starije životne dobi. U 2017. godini
je bilo više hospitaliziranih žena sa sindromom sepse, dok je 2022. godine bilo više
hospitaliziranih muškaraca sa sindromom sepse. Najčešći predispozicijski čimbenik za razvoj
sepse su 2017. i 2022. godine bile kardiovaskularne bolesti s tim da je incidencija svih
predispozicijskih čimbenika za razvoj sepse bila veća u 2022. godini nego u 2017. godini.
Charlson Comorbidity Index, odnosno pokazatelj težine komorbididteta bolesnika je značajno
veći u bolesnika sa sepsom hospitaliziranih 2022. godine. U 2017. godini je češće identificiran
uzročnik sepse, gram-negativni osjetljivi bacil, dok je 2022. godine značajniji udio hemokultura
bio negativan. Najčešće ishodište sepse je obje godine bio mokraćni sustav. U 2017. godini je
terapija uključivala rezervni antibiotik, odnosno kombinaciju antibiotika prve linije i rezervnog
antibiotika. U 2022. godini je najčešće primjenjivana kombinacija antibiotika, ali se koristilo
više rezervnih antibiotika nego 2017. godine. Unatoč činjenici da su hospitalizirani bolesnici
bili opterećeni s više komorbiditeta, imali više komplikacija te su češće primijenjivani
antibiotici rezerve ipak je trajanje hospitalizacije oboljelih od sepse u Klinici za infektologiju
2022. godine bilo znatno kraće u odnosu na 2017. godinu. |
| Abstract (english) | Objectives: To present and compare the frequency of sepsis diagnosis, clinical, microbiological
and therapeutic characteristics of patients with sepsis hospitalized in 2017 and 2022.
Materials and methods: The study included 266 patients with a diagnosis of sepsis who were
treated at Clinic for Infectious Diseases of University Hospital of Split in 2017 and 2022. The
research is a retrospective study conducted by examining the patients medical documentation.
Results: The median age of patients hospitalized for sepsis in 2017 and 2022 was 75 years.
Women accounted for 60% of hospitalized patients with sepsis in 2017, while men accounted
for 54.8% of hospitalized patients with sepsis in 2022. The most common chronic, predisposing
factor for the development of sepsis in 2017 (60%) and 2022 (74%) was a cardiovascular system
disease. In 2017, the most common causative agents were gram-negative susceptible bacilli
(53.3%), while in 2022, blood cultures were negative in most cases (45.2%). The most common
source of sepsis in 2017 (61.7%) and 2022 (34.9%) was the urinary system. In 2017, in 35% of
cases, patients were treated with a combination of first-line antibiotics and a reserve antibiotic,
or in 35% of cases only with a reserve antibiotic. In 2022, 37.7% of patients with sepsis were
treated with a combination of first-line antibiotics and a reserve antibiotic. The median duration
of hospitalization for patients diagnosed with sepsis was 12 days in 2017, and 6 days in 2022.
The most common outcome in both years was favorable, i.e. 70% of patients with sepsis
survived in 2017, while 52.7% survived in 2022.
Conclusions: Sepsis syndrome most often affects older people. In 2017, there were more
hospitalized women with sepsis syndrome, while in 2022 there were more hospitalized men
with sepsis syndrome. The most common predisposing factor for the development of sepsis in
2017 and 2022 were cardiovascular diseases, with the incidence of all predisposing factors for
the development of sepsis higher in 2022 than in 2017. The Charlson Comorbidity Index, i.e.
the indicator of the severity of the patient's comorbidity, is significantly higher in patients with
sepsis hospitalized in 2022. In 2017, the causative agent of sepsis, gram-negative sensitive
bacillus, was identified more often, while in 2022, a significant proportion of blood cultures
were negative. The most common source of sepsis in both years was the urinary system. In
2017, therapy included a reserve antibiotic, i.e. a combination of first-line antibiotics and a
reserve antibiotic. In 2022, a combination of antibiotics was most often used, but more reserve
antibiotics were used than in 2017. Despite the fact that hospitalized patients were burdened
with more comorbidities, had more complications, and reserve antibiotics were used more
53
often, the duration of hospitalization of sepsis patients at the Clinic for Infectious Diseases in
2022 was significantly shorter compared to 2017. |
