Perfil epidemiológico da sepse e choque séptico em um hospital do oeste do Estado de Santa Catarina

Abstract

Sepsis and septic shock constitute significant public health problems, ranking among the leading causes of hospital mortality worldwide, especially in intensive care units (ICUs). National data show a high mortality rate, exceeding 55% in public hospitals, a scenario that reflects structural inequalities, diagnostic limitations, and low adherence to standardized care protocols. Within this context, the study described the prevalence of sepsis and septic shock cases and characterized the clinical-epidemiological profile in patients hospitalized in a hospital in Western Santa Catarina. This is a quantitative study, with a retrospective and prospective design, of an observational and cross-sectional nature, with documentary analysis of medical records and data collection from nursing professionals, developed in a large public hospital located in the western region of the state of Santa Catarina, where 1,619 patients hospitalized between March 2020 and June 2025 were evaluated. Of the total, 26.7% presented sepsis, 28.8% progressed to septic shock, and 44.4% did not have a diagnosis of sepsis. During the study, a high proportion of septic shock was observed, indicating the severity of the cases treated and a possible delay in clinical recognition. The majority of patients were male (59.8%) and between 51 and 80 years old. Professions such as farmers, homemakers, and drivers were the main occupational activities, and most identified as Catholic. The racial distribution showed a higher prevalence of white people, a demographic characteristic of the region. In order to contextualize the theoretical review, the evolution of sepsis definitions was highlighted, from the SIRS criteria to Sepsis-3, emphasizing the importance of early identification through SOFA and qSOFA scores. The study analyzed 1619 ICU patients from March 2020 to June 2025, distributed as follows: 433 (26.7%) with sepsis, 467 (28.8%) with septic shock (CS), and 719 (44.4%) without sepsis, with no significant temporal variation (ANOVA). Demographically, men predominated (59.8%), the age range was 51-80 years, farmers (28.4%), housewives (13.4%), drivers (6.2%), and Catholics (75%), with predominantly white skin. Total organ dysfunctions amounted to 2854, led by metabolic (27.7%), pulmonary (26.7%), and renal (21.5%) disorders; Comorbidities in 2136 cases include hypertension (23.5%), cancer (12.9%), and diabetes (12.6%). Clinical signs (2348) highlight tachypnea (30.1%), tachycardia (29.7%), and hypoxemia (18.7%); laboratory tests reveal elevated CRP (98.7%), high urea (91.8%), altered lactate (84%), creatinine (67.9%), and thrombocytopenia (44.4%). Infectious foci (1124) are pulmonary (54.6%), with Klebsiella pneumoniae prevalent in tracheal aspirate (27.5%), Candida spp. in urine culture (37.9%), and Staphylococcus spp. in blood culture (43.6%); total antibiotics (2598) prioritize carbapenems (19.4%). Prognosis indicates a mortality rate of 52.6% in sepsis/CS (43.8% and 50.8%), with hospitalization of 2-20 days and a positive correlation (r=0.9973), in addition to the scarce application of prognostic scores (94.9% absent), aligning with the Brazilian literature on heterogeneity and the need for bundles.