SEPSIS SYNDROME AND ASSOCIATED SEQUELAE IN PATIENTS AT HIGH-RISK FOR GRAM-NEGATIVE SEPSIS

We conducted a prospective surveillance study of 80 hospitals across t he United States to determine the incidence of sepsis syndrome and its associated sequelae in hospitalized patients over age 18 years who we re administered antibiotics for suspected or documented gram-negative infection. A sample of 1754 hospitalized patients were followed from o nset of antimicrobial therapy to discharge or death. Mortality rates ( MR) varied depending on the suspected source of sepsis syndrome. For p atients in whom the syndrome was associated with community-acquired ur inary tract infections, mortality was 20% (relative risk [RR] = 0.51, p<0.05), for those with trauma 20.6% (RR = 0.51, p<0.05), and patients with nosocomial respiratory tract infections 57.1% (RR = 1.66, p<0.05 ). More than two complications occurred in 65.2% of patients under age 60 years (MR 31%), 40.8% of those age 60-80 (MR 42%), and 35.6% of pa tients older than 80 years (MR 33.3%, p>0.05). Various patient populat ions had significant differences in both the incidence of the syndrome and its complications, and consequent mortality. Perhaps morbidity as well as mortality should be used as outcomes when testing the efficac y of innovative therapies for sepsis.