The Epidemiology, Therapeutic Patterns, Outcome, and Challenges in Managing Septic Shock in a Sub-Saharan African Intensive Care Unit: A Cross-Sectional Study

Document Type: Original Article

Authors

1 Department of Anesthesiology and Critical Care, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon

2 Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon

3 Department of Emergency Medicine, Anesthesiology and Critical Care, Douala General Hospital, Douala, Cameroon

4 Department of Anesthesiology and Critical Care, Gynaeco-Obstetrics and Paediatric Hospital, Yaoundé, Cameroon

Abstract

Background: Septic shock (SS) is a health priority in sub-Saharan Africa. However, there is a dearth of data in this regard.
Objective: This study aimed to determine the epidemiology, therapeutic patterns, outcome, and challenges in managing SS in a tertiary intensive care unit (ICU) of sub-Saharan Africa.
Methods: The hospital files of 36 consecutive patients admitted to the ICU of the Douala General Hospital (DGH), Cameroon over the year 2018 were reviewed for SS. SS was diagnosed based on Sepsis-3 definition. Demographic and clinical characteristics, treatment details, and outcomes of patients with SS were reviewed. Data was analyzed using the chi-square or Fisher exact tests and Bonferroni correction.
Results: SS accounted for 36 (9.4%) ICU admissions. The majority of patients were males (63.9%). The most common site of infection was the lungs. The mean age, average mean arterial pressure (MAP), and mean sequential organ failure assessment (SOFA) score of patients were 52.9±25.2 years, 52±18 mm Hg, and 9.2 ±2.3, respectively. Noradrenaline was the sole vasopressor used. Therapeutic challenges included the inability to have a specific antibiogram before a mean duration of 7 days. The mortality rate was 39% and associated with age ≤1 year, MAP ≤ 65 mm Hg, Glasgow Coma Score (GCS) ≤8, and mechanical ventilation, which were not attenuated after Bonferroni correction.
Conclusion: SS is a frequent cause of ICU admission and is associated with a high mortality rate. SS mortality-related factors can be screened during SS management for more aggressive ICU management geared at preventing death.

Keywords



Articles in Press, Accepted Manuscript
Available Online from 05 November 2019
  • Receive Date: 20 July 2019
  • Revise Date: 02 October 2019
  • Accept Date: 19 October 2019