Sepsis the Most Common Peril in General Surgery Patients

Sepsis and septic shock are more prevalent than pulmonary embolism (PE) and myocardial infarction (MI) in general surgery patients, according to a new study.

Researchers at the Methodist Hospital Weill Cornell Medical College (Houston, TX, USA) conducted a retrospective review of all general-surgery patients included in the 2005-2007 U.S. national surgical quality improvement program data set maintained by the American College of Surgeons (ACS; Chicago, IL, USA). The researchers documented the incidence, mortality rate, and risk factors for sepsis and septic shock, compared with PE and ME in the general-surgery population. The main outcome measures were incidence, mortality rate, and risk factors for sepsis and septic shock.

The results showed that of 363,897 general surgery patients, sepsis occurred in 8,350 (2.3%), septic shock in 5,977 (1.6%), PE in 1,078 (0.3%), and MI in 615 (0.2%); the septic-shock group had a greater percentage of patients older than 60 years. Thirty-day mortality rates for each of the groups were as follows: 5.4% for sepsis, 33.7% for septic shock, 9.1% for PE, and 32% for MI. The need for emergency surgery resulted in more cases of sepsis (4.5%) and septic shock (4.9%) than did elective surgery. The presence of any comorbidity increased the risk of sepsis and septic shock 6-fold, and increased the 30-day mortality rate 22-fold. The study was published in the July 2010 issue of the Archives of Surgery.

"Mortality rates in patients with sepsis and septic shock exceed those of MI and PE combined by nearly 10-fold,” concluded lead author Laura Moore, M.D., and colleagues of the department of surgery. "Therefore, our level of vigilance in identifying sepsis and septic shock needs to mimic, if not surpass, our vigilance for identifying MI and PE. Further evaluation of the role of sepsis screening programs in other settings is critical and could significantly reduce sepsis-related mortality in general-surgery patients.”

Related Links:
Methodist Hospital Weill Cornell Medical College
American College of Surgeons