Lethality in patients with complicated diabetic foot syndrome and signs of sepsis in accordance to recommendations «Sepsis-3»
Objective. To conduct analysis of lethality indices in patients with sepsis on background of complicated diabetic foot syndrome (DFS), taking into account a protocol of Conciliation Conference (1992) and recommendations of ІІІ International Consensus for determination of sepsis and septical shock («Sepsis-3»).
Маterials and methods. There were analyzed 938 medical files of patients, suffering complicated DFS. In 92 (9.8%) patients the disease was complicated by sepsis. In accordance to «Sepsis-3» recommendations a new scale was applied during examination near the bed - qSOFA.
Results. Аnalysis of lethal cases, taking into account «Sepsis-3» recommendations, have shown, that some forms of septic process were referred to complicated unjustifiably, i. e. their quantitative value in accordance to qSOFA scale did not exceeded 1 point. This gave possibility to determine a sepsis as the death cause in 5 (11.9%) patients, аnd as a septic shock - in 37 (88.1%).
Conclusion. The «Sepsis-3» recommendations introduction into clinical practice would prevent disagreements while the diagnosis determination. It is possible without significant material expenses and rapidly to differentiate sepsis and septical shock, using qSOFA scale.
2. Rhodes A, Evans LE, Alhazzani W, Levy MM, Antonelli M, Ferrer R, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock: 2016. Intensive Care Med. 2017 Mar;43(3):304-77. doi: 10.1007/s00134-017-4683-6. Epub 2017 Jan 18. PMID: 28101605.
3. Byrne L, Van Haren F. Fluid resuscitation in human sepsis: Time to rewrite history? Ann Intensive Care. 2017 Dec;7(1):4. doi: 10.1186/s13613-016-0231-8. Epub 2017 Jan 3..
4. Singer M, Deutschman CS, Seymour CW, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). YAMA. 2016;315(8):801-10.
5. Trybushnyi OV, Shapoval SD, Savon IL, Novak VV. Аnalysis of lethality in complicated diabetic foot syndrome and sepsis. Klinichna khirurhiia. 2017;(1):58-60. [In Ukranian].
6. Bone RC. The pathogenesis of sepsis Ann. Int Med. 1991;115:457-69.
7. Dellingeretal RP. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med. 2013 Feb;41(2):580-637.
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