Current practice of management of bacteremic sepsis: A study in a tertiarycare teaching hospital in Japan

Objective To investigate how patients with bacteremic sepsis are managed in a tertiary care teaching hospital. Patients and Methods Prospective observational study on patients with bacte remic sepsis, Clinical and microbiological characteristics of bacteremic se psis were analyzed in relation to prognosis, Severity of the illness was qu antitatively analyzed by the APACHE (Acute Physiology, Age, Chronic Health Evaluation) III scoring system. Also investigated was how closely physician s paid attention to acute physiological alterations in patients. Results The 28-day mortalities in fifty hemodynamically stable patients and in twenty-three septic shock patients were 26% and 52%, respectively (p=0. 028), Grampositive organisms accounted for 54% of all organisms, with the m ortality and incidence of septic shock being the same as with Gram-negative infections, The mean APACHE III score was 42.9 in survivors, and 76.5 in n on-survivors (p < 0.001). Although serum levels of C-reactive protein and a cute physiology score (APS) was significantly higher in non-survivors than in survivors, the correlation with APACHE III score was more prominent in A PS, The number of vital signs recorded was 1.67 in physicians and 3.6 in nu rses (p < 0.001), Conclusions The present study proved that the APACHE III score accurately d iscriminates between survivors and non-survivors of patients with sepsis, B y addressing the need for an objective evaluation of severity of illness, i t strongly recommends that physicians should be made aware of physiological ly defined sepsis and that they should pay closer attention to patients' ph ysiological alterations to identify the development of sepsis in critically ill patients.