Management Characteristics and Outcomes of Adolescents and Adults With Sepsis, Northern Tanzania, September 2019–April 2020
| . | Total Cohort (n = 86) . | Sepsis Without Hypotension (n = 82) . | Sepsis With Hypotension (n = 4) . |
|---|---|---|---|
| Management characteristics, h 0–6 | |||
| Received antimicrobials by 2 h | 14 (16.3) | 14 (17.1) | 0 |
| Received antimicrobials by 6 h | 29 (33.7) | 29 (35.4) | 0 |
| If received, time to antimicrobials by h 6, median (IQR), min | 129 (97–203) | 129 (97–203) | n/a |
| Received any IV fluids by 3 h | 42 (51.2) | 38 (46.3) | 4 (100) |
| Received any IV fluids by 6 h | 49 (57.0) | 45 (54.9) | 4 (100) |
| <1L IV fluids | 23 (46.9) | 20 (44.4) | 3 (75.0) |
| 1–2L IV fluids | 21 (42.9) | 20 (44.4) | 1 (25.0) |
| >2L IV fluids | 5 (10.2) | 5 (11.1) | 0 |
| If received, total IV fluids by h 6, median (IQR), mL | 1000 (500–1500) | 1000 (500–1500) | 500 (350–750) |
| Blood cultures performed | 26 (30.2) | 25 (30.5) | 1 (25.0) |
| If performed, obtained before antimicrobials given | 24 (92.3) | 23 (92.0) | 1 (100) |
| Other investigation for infectious source performeda | 65 (75.6) | 63 (76.8) | 2 (50.0) |
| Steroid administration | 3 (3.5) | 3 (3.7) | 0 |
| Supplemental oxygen given | 17 (19.8) | 17 (20.7) | 0 |
| Required emergent surgery | 1 (1.2) | 1 (1.2) | 0 |
| Hospital course | |||
| Received ≥1 antimicrobial after admission | 48 (55.8) | 45 (54.9) | 3 (75.0) |
| Required vasopressors at any time | 2 (2.3) | 2 (2.4) | 0 |
| Required supplemental oxygen at any time | 27 (31.4) | 26 (31.7) | 1 (25.0) |
| Intensive care unit at any time | 17 (19.8) | 16 (19.5) | 1 (25.0) |
| Outcomes | |||
| In-hospital death | 25 (29.1) | 24 (29.3) | 1 (25.0) |
| Length of stay, median (range), d | 4.5 (1–8) | 4.5 (1–8) | 5.5 (2.5–8) |
| Deaths by qSOFA and UVA scoresb | … | … | … |
| qSOFA <2 | 9 (17.0) of 53 | 9 (17.0) of 53 | 0 of 0 |
| qSOFA ≥2 | 16 (48.5) of 33 | 15 (51.7) of 29 | 1 (25.0) of 4 |
| UVA <2 | 4 (10.5) of 38 | 4 (10.8) of 37 | 0 (0) of 1 |
| UVA 2–4 | 9 (30.0) of 30 | 9 (31.0) of 29 | 0 (0) of 1 |
| UVA ≥5 | 12 (66.7) of 18 | 11 (68.8) of 16 | 1 (50.0) of 2 |
| . | Total Cohort (n = 86) . | Sepsis Without Hypotension (n = 82) . | Sepsis With Hypotension (n = 4) . |
|---|---|---|---|
| Management characteristics, h 0–6 | |||
| Received antimicrobials by 2 h | 14 (16.3) | 14 (17.1) | 0 |
| Received antimicrobials by 6 h | 29 (33.7) | 29 (35.4) | 0 |
| If received, time to antimicrobials by h 6, median (IQR), min | 129 (97–203) | 129 (97–203) | n/a |
| Received any IV fluids by 3 h | 42 (51.2) | 38 (46.3) | 4 (100) |
| Received any IV fluids by 6 h | 49 (57.0) | 45 (54.9) | 4 (100) |
| <1L IV fluids | 23 (46.9) | 20 (44.4) | 3 (75.0) |
| 1–2L IV fluids | 21 (42.9) | 20 (44.4) | 1 (25.0) |
| >2L IV fluids | 5 (10.2) | 5 (11.1) | 0 |
| If received, total IV fluids by h 6, median (IQR), mL | 1000 (500–1500) | 1000 (500–1500) | 500 (350–750) |
| Blood cultures performed | 26 (30.2) | 25 (30.5) | 1 (25.0) |
| If performed, obtained before antimicrobials given | 24 (92.3) | 23 (92.0) | 1 (100) |
| Other investigation for infectious source performeda | 65 (75.6) | 63 (76.8) | 2 (50.0) |
| Steroid administration | 3 (3.5) | 3 (3.7) | 0 |
| Supplemental oxygen given | 17 (19.8) | 17 (20.7) | 0 |
| Required emergent surgery | 1 (1.2) | 1 (1.2) | 0 |
| Hospital course | |||
| Received ≥1 antimicrobial after admission | 48 (55.8) | 45 (54.9) | 3 (75.0) |
| Required vasopressors at any time | 2 (2.3) | 2 (2.4) | 0 |
| Required supplemental oxygen at any time | 27 (31.4) | 26 (31.7) | 1 (25.0) |
| Intensive care unit at any time | 17 (19.8) | 16 (19.5) | 1 (25.0) |
| Outcomes | |||
| In-hospital death | 25 (29.1) | 24 (29.3) | 1 (25.0) |
| Length of stay, median (range), d | 4.5 (1–8) | 4.5 (1–8) | 5.5 (2.5–8) |
| Deaths by qSOFA and UVA scoresb | … | … | … |
| qSOFA <2 | 9 (17.0) of 53 | 9 (17.0) of 53 | 0 of 0 |
| qSOFA ≥2 | 16 (48.5) of 33 | 15 (51.7) of 29 | 1 (25.0) of 4 |
| UVA <2 | 4 (10.5) of 38 | 4 (10.8) of 37 | 0 (0) of 1 |
| UVA 2–4 | 9 (30.0) of 30 | 9 (31.0) of 29 | 0 (0) of 1 |
| UVA ≥5 | 12 (66.7) of 18 | 11 (68.8) of 16 | 1 (50.0) of 2 |
Data are presented as No. (%) unless otherwise noted.
Abbreviations: IQR, interquartile range; IV, intravenous; qSOFA, quick Sequential Organ Failure Assessment; UVA, Universal Vital Assessment.
aIncludes rapid HIV test, malaria rapid diagnostic test, urinalysis, urine culture, lumbar puncture, sputum culture, or any sputum acid-fast bacilli test, or any method of imaging.
bGiven as [# deaths] (%) of [# of cohort or subgroup in score category].
Management Characteristics and Outcomes of Adolescents and Adults With Sepsis, Northern Tanzania, September 2019–April 2020
| . | Total Cohort (n = 86) . | Sepsis Without Hypotension (n = 82) . | Sepsis With Hypotension (n = 4) . |
|---|---|---|---|
| Management characteristics, h 0–6 | |||
| Received antimicrobials by 2 h | 14 (16.3) | 14 (17.1) | 0 |
| Received antimicrobials by 6 h | 29 (33.7) | 29 (35.4) | 0 |
| If received, time to antimicrobials by h 6, median (IQR), min | 129 (97–203) | 129 (97–203) | n/a |
| Received any IV fluids by 3 h | 42 (51.2) | 38 (46.3) | 4 (100) |
| Received any IV fluids by 6 h | 49 (57.0) | 45 (54.9) | 4 (100) |
| <1L IV fluids | 23 (46.9) | 20 (44.4) | 3 (75.0) |
| 1–2L IV fluids | 21 (42.9) | 20 (44.4) | 1 (25.0) |
| >2L IV fluids | 5 (10.2) | 5 (11.1) | 0 |
| If received, total IV fluids by h 6, median (IQR), mL | 1000 (500–1500) | 1000 (500–1500) | 500 (350–750) |
| Blood cultures performed | 26 (30.2) | 25 (30.5) | 1 (25.0) |
| If performed, obtained before antimicrobials given | 24 (92.3) | 23 (92.0) | 1 (100) |
| Other investigation for infectious source performeda | 65 (75.6) | 63 (76.8) | 2 (50.0) |
| Steroid administration | 3 (3.5) | 3 (3.7) | 0 |
| Supplemental oxygen given | 17 (19.8) | 17 (20.7) | 0 |
| Required emergent surgery | 1 (1.2) | 1 (1.2) | 0 |
| Hospital course | |||
| Received ≥1 antimicrobial after admission | 48 (55.8) | 45 (54.9) | 3 (75.0) |
| Required vasopressors at any time | 2 (2.3) | 2 (2.4) | 0 |
| Required supplemental oxygen at any time | 27 (31.4) | 26 (31.7) | 1 (25.0) |
| Intensive care unit at any time | 17 (19.8) | 16 (19.5) | 1 (25.0) |
| Outcomes | |||
| In-hospital death | 25 (29.1) | 24 (29.3) | 1 (25.0) |
| Length of stay, median (range), d | 4.5 (1–8) | 4.5 (1–8) | 5.5 (2.5–8) |
| Deaths by qSOFA and UVA scoresb | … | … | … |
| qSOFA <2 | 9 (17.0) of 53 | 9 (17.0) of 53 | 0 of 0 |
| qSOFA ≥2 | 16 (48.5) of 33 | 15 (51.7) of 29 | 1 (25.0) of 4 |
| UVA <2 | 4 (10.5) of 38 | 4 (10.8) of 37 | 0 (0) of 1 |
| UVA 2–4 | 9 (30.0) of 30 | 9 (31.0) of 29 | 0 (0) of 1 |
| UVA ≥5 | 12 (66.7) of 18 | 11 (68.8) of 16 | 1 (50.0) of 2 |
| . | Total Cohort (n = 86) . | Sepsis Without Hypotension (n = 82) . | Sepsis With Hypotension (n = 4) . |
|---|---|---|---|
| Management characteristics, h 0–6 | |||
| Received antimicrobials by 2 h | 14 (16.3) | 14 (17.1) | 0 |
| Received antimicrobials by 6 h | 29 (33.7) | 29 (35.4) | 0 |
| If received, time to antimicrobials by h 6, median (IQR), min | 129 (97–203) | 129 (97–203) | n/a |
| Received any IV fluids by 3 h | 42 (51.2) | 38 (46.3) | 4 (100) |
| Received any IV fluids by 6 h | 49 (57.0) | 45 (54.9) | 4 (100) |
| <1L IV fluids | 23 (46.9) | 20 (44.4) | 3 (75.0) |
| 1–2L IV fluids | 21 (42.9) | 20 (44.4) | 1 (25.0) |
| >2L IV fluids | 5 (10.2) | 5 (11.1) | 0 |
| If received, total IV fluids by h 6, median (IQR), mL | 1000 (500–1500) | 1000 (500–1500) | 500 (350–750) |
| Blood cultures performed | 26 (30.2) | 25 (30.5) | 1 (25.0) |
| If performed, obtained before antimicrobials given | 24 (92.3) | 23 (92.0) | 1 (100) |
| Other investigation for infectious source performeda | 65 (75.6) | 63 (76.8) | 2 (50.0) |
| Steroid administration | 3 (3.5) | 3 (3.7) | 0 |
| Supplemental oxygen given | 17 (19.8) | 17 (20.7) | 0 |
| Required emergent surgery | 1 (1.2) | 1 (1.2) | 0 |
| Hospital course | |||
| Received ≥1 antimicrobial after admission | 48 (55.8) | 45 (54.9) | 3 (75.0) |
| Required vasopressors at any time | 2 (2.3) | 2 (2.4) | 0 |
| Required supplemental oxygen at any time | 27 (31.4) | 26 (31.7) | 1 (25.0) |
| Intensive care unit at any time | 17 (19.8) | 16 (19.5) | 1 (25.0) |
| Outcomes | |||
| In-hospital death | 25 (29.1) | 24 (29.3) | 1 (25.0) |
| Length of stay, median (range), d | 4.5 (1–8) | 4.5 (1–8) | 5.5 (2.5–8) |
| Deaths by qSOFA and UVA scoresb | … | … | … |
| qSOFA <2 | 9 (17.0) of 53 | 9 (17.0) of 53 | 0 of 0 |
| qSOFA ≥2 | 16 (48.5) of 33 | 15 (51.7) of 29 | 1 (25.0) of 4 |
| UVA <2 | 4 (10.5) of 38 | 4 (10.8) of 37 | 0 (0) of 1 |
| UVA 2–4 | 9 (30.0) of 30 | 9 (31.0) of 29 | 0 (0) of 1 |
| UVA ≥5 | 12 (66.7) of 18 | 11 (68.8) of 16 | 1 (50.0) of 2 |
Data are presented as No. (%) unless otherwise noted.
Abbreviations: IQR, interquartile range; IV, intravenous; qSOFA, quick Sequential Organ Failure Assessment; UVA, Universal Vital Assessment.
aIncludes rapid HIV test, malaria rapid diagnostic test, urinalysis, urine culture, lumbar puncture, sputum culture, or any sputum acid-fast bacilli test, or any method of imaging.
bGiven as [# deaths] (%) of [# of cohort or subgroup in score category].
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