Table of Contents Author Guidelines Submit a Manuscript
Critical Care Research and Practice
Volume 2010, Article ID 436427, 7 pages
http://dx.doi.org/10.1155/2010/436427
Clinical Study

Epidemiology, Prognosis, and Evolution of Management of Septic Shock in a French Intensive Care Unit: A Five Years Survey

Intensive Care and Infectious Disease Unit, Tourcoing Hospital, University of Lille, 135, rue du Président Coty, BP 619, 59208 Tourcoing, France

Received 18 November 2009; Accepted 29 April 2010

Academic Editor: Jordi Rello

Copyright © 2010 Nicolas Boussekey et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose. To evaluate the epidemiology, prognosis, and management of septic shock patients hospitalized in our intensive care unit (ICU). Materiel and Methods. Five-year monocenter observational study including 320 patients. Results. ICU mortality was 54.4%. Independent mortality risk factors were mechanical ventilation ( O R = 4 . 9 7 ), Simplify Acute Physiology Score (SAPS) II > 60 ( O R = 4 . 2 8 ), chronic alcoholism ( O R = 3 . 3 8 ), age >65 years ( O R = 2 . 6 5 ), prothrombin ratio <40% ( O R = 2 . 3 7 ), and P a O 2 / F i O 2 ratio <150 ( O R = 1 . 9 1 ). These six mortality risk factors recovered allow screening immediately septic shock patients with a high mortality risk. Morbidity improved with time (diminution of septic shock complications, increase of the number of days alive free from mechanical ventilation and vasopressors on day 28), concomitant to an evolution of the management (earlier institution of all replacement and medical therapies and more initial volume expansion). There was no difference in mortality. Conclusion. Our study confirms a high mortality rate in septic shock patients despite a new approach of treatment.