Clinical Characteristics and Mortality in Community-Acquired Sepsis and Septic Shock Patients in the Intensive Care Unit Setting in Latvia: An Observational Study

Abstract

Background: Sepsis and septic shock are medical emergencies with increasing incidence and high intrahospital mortality rates, as they are common causes of admission to the intensive care units (ICU). Early recognition and adequate treatment are important in reducing mortality. Limited data are available on characteristics and outcomes of community-acquired sepsis and septic shock in Latvia. Methods: In this single-center cohort study, we explore clinical characteristics and outcomes of 86 community-acquired sepsis and septic shock cases admitted to the ICU of a clinical university hospital between 2014 and 2018. Results: The ICU and intrahospital mortality rates were 45% and 58%, respectively. Respiratory tract infections, particularly pneumonia and abdominal and skin/soft tissue infections, were the most common sites of origin. Overall, 95% of patients initially received appropriate antibiotic treatment. However, the median time to antibiotics was 225 min (IQR 118–407 min), and only 10% received antimicrobial treatment within 1 h. Conclusions: The number of patients enrolled indicates that sepsis cases are underreported on a national level. The results also demonstrate high mortality rates among ICU patients with community-acquired sepsis and septic shock, compared to other reports. The analysis indicates that early recognition of sepsis signs and organ failure is crucial for improvements in treatment outcomes.