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

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 ۳۶ consecutive patients admitted to the ICU of the Douala General Hospital (DGH), Cameroon over the year ۲۰۱۸ were reviewed for SS. SS was diagnosed based on Sepsis-۳ 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 ۳۶ (۹.۴%) ICU admissions. The majority of patients were males (۶۳.۹%). 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 ۵۲.۹±۲۵.۲ years, ۵۲±۱۸ mm Hg, and ۹.۲ ±۲.۳, respectively. Noradrenaline was the sole vasopressor used. Therapeutic challenges included the inability to have a specific antibiogram before a mean duration of ۷ days. The mortality rate was ۳۹% and associated with age ≤۱ year, MAP ≤ ۶۵ mm Hg, Glasgow Coma Score (GCS) ≤۸, 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.

کلیدواژه ها:

Septic ، Shock ، Epidemiology ، intensive care ، Sub-Saharan Africa