Intra-abdominal Sepsis – epidemiology and clinical presentation

Abstract

Severe Sepsis (acute organ dysfunction secondary to infection) and septic shock (severe sepsis plus hypotension not reversed with fluid resuscitation) are major healthcare problems, affecting millions of individuals around the world each year, killing one in four (and often more), and increasing in incidence [1].  Incidence increased from 82 to 240/100,000 population  Men > women 1.28 CI  Reduced mortality rate 27 to 18%  Highest mortality black men  Decreased length of hospital stay  Increased discharge to chronic care  Predominance gram positive organism after 1987  Fungal organism increase 207 % Similar to major trauma, acute myocardial infarction or stroke, the speed and appropriateness of therapy administered in the initial hours after severe sepsis develops are likely to influence outcome. In 2004, an international group of experts in the diagnosis and management of infection and sepsis, representing 11 organizations, published the first internationally accepted guidelines that the bedside clinician could use to improve outcomes in severe sepsis and septic shock [2]. These guidelines represented phase II of the Surviving Sepsis Campaign (SSC) an international effort to increase awareness and improve outcomes in severe sepsis. Joined by additional organizations the group met again in 2006 and 2007 to update the guidelines document using a new evidence-based methodology system for assessing quality of evidence and strength of recommendations [3].