Sepsis in the nonhospital setting

Abstract

Abstract Introduction Sepsis is a disease with high mortality and morbidity. Despite advances in diagnosis and therapeutic packages, many gaps remain. This study aimed to evaluate the profile and outcomes of out-of-hospital sepsis. Methods This was a retrospective study, multicenter study including five basic health Unit. The study period was from January 2018 to December 2021.Patients diagnosed with sepsis or septic shock according to the Sepsis 3.0 criterion. Results A total 2630 patients were included with a diagnosis of sepsis 68.4% (1800) or septic shock 31.6% (830) in the emergency care units. The comorbidities that were independent predictors of septic shock were chronic kidney disease on dialysis (CKD-d), bone marrow transplantation and neoplasia; CKD and neoplasia were also independent predictors of mortality, with ORs of 2.00 (CI 1.10–3.68) p = 0.023 and 1.74 (CI 1.319–2.298) p = < 0.0001, respectively. Mortality according to the focus of primary infection was as follows: pulmonary 40.1%; COVID-19 35.7%; abdominal 8.1% and urinary 6.2%. Mortality due to the COVID-19 outbreak had an OR of 4.94 (CI 3.08–8.13) p ≤ 0.0001. Conclusions The following are risk factors associated with mortality in nonhospitalized sepsis: comorbidities (d-CKD and neoplasia) and the primary focus of COVID-19 infection.