Prevalence and outcome of sepsis and septic shock in intensive care units in Addis Ababa, Ethiopia: A prospective observational study

Background: Sepsis and septic shock are the major causes of morbidity and mortality in Intensive care Units (ICUs) in low and middle-income countries. However, little is known about their prevalence and outcome in these settings. The study aimed to assess the prevalence and outcome of sepsis and septic shock in ICUs in Addis Ababa, Ethiopia. Methods: A prospective observational study was conducted from March 2017 to February 2018 in four selected ICUs in Addis Ababa from a total of twelve hospitals having ICU services. There were 1145 total ICU admissions during the study period. All admissions into those ICUs with sepsis, severe sepsis, and septic shock using the Systemic Inflammatory Response Syndrome (SIRS) criteria (SEPSIS-2) during the study period were screened for sepsis or septic shock based on the new sepsis definition (SEPSIS-3). All patients with sepsis and septic shock during ICU admission were included and followed for 28 days of ICU admission. Data analysis was done using the Statistical Package for Social Sciences (SPSS) software version 20.0. Results: A total of 275 patients were diagnosed with sepsis and septic shock. The overall prevalence of sepsis and septic shock was 26.5 per 100 ICU admissions. The most frequent source of sepsis was respiratory infection (53.1%). The median length of stay in the ICUs was 5 (IQR, 2-8) days. The most common bacterium isolate was Pseudomonas aeroginosa (34.5%). The ICU and 28-day mortality rate was 41.8% and 50.9% respectively. Male sex, modified Sequential Organ Failure Assessment score >= 10 on day 1 of ICU admission, and comorbidity of HIV or malignancy were the independent predictors of 28-day mortality. Conclusion: Sepsis and septic shock are common among our ICU admissions, and are associated with a high mortality rate.