DOI: 10.11648/j.ijacm.20261402.16 ISSN: 2997-2698

Sepsis in the Intensive Care Units in the Republic of Congo in 2024: Epidemiological Aspects and Factors Associed with Death

Elombila Marie, Mpoy Mayick, Nakavoua Zozer, Niengo Gilles, Bayoundoula Ghislaine, Nde Aurole, Iwoba Armanda, Kibamba Isaac, Boyewi Jeancia, Koumou Regis, Otiobanda Fabrice
Show PDF Cite
Sepsis is a major public health problem in the world, especially with the emergence of multi-resistant bacteria. The frequency of admission of septic patients to intensive care is gradually increasing. In Africa, few data are available on sepsis, and the factors associated with sepsis mortality remain unclear. The aim was to analyze the epidemiological profile and factors associated with sepsis mortality in intensive care units (ICUs) in the Republic of Congo. This was a prospective, multicenter, longitudinal cohort study covering the period from March 1 to August 31, 2024. It took place in four ICUs in the Republic of Congo. We included patients admitted for sepsis ICUs of the centers selected for the study, aged at least 18 years, presenting at least two elements of SIRS and/or a qSOFA ≥ 2, associated with a presumptive or confirmed infection. Study variables were: sociodemographic, clinical, paraclinical, SOFA score, therapeutic and outcomes. Data analysis was performed using IBM-SPSS version 20 software. Quantitative variables were expressed as mean with standard deviation, and qualitative variables as numbers with frequencies. We performed two types of analysis: a univariate analysis and a multivariate analysis to identify factors associated with mortality. A total of 156 patients were registered, representing a frequency of 17.8%. The median age was 45 years, with a sex ratio of 1.02. The majority of patients (64%) had comorbidities domined by high blood pression and diabetes mellitus. The main reasons for admission were impaired consciousness (57.7%) and hemodynamic instability (40.4%). The most common sites were digestive and neuromeningeal in 30.1% respectively. Patients had a GCS between 9 -12 (39.1%), arterial hypotension (41%), SpO 2 ≤ 92% (25.6%) and diuresis < 0.5 ml/kg/h (48.1%). Patients had a SOFA score (7-14) in 62.8%. The two most frequent organ failures were neurological (63.5%) and renal (57.7%). Double antibiotherapy was used in the majority of cases (47.9%). We recorded a mortality rate of 33.3%. Median length of stay was 3 days [range: 2-7 days]. Factors associated with mortality were altered consciousness (ORa: 2.82; adjusted p = 0.008), surgical treatment (ORa: 3.57; adjusted p = 0.032), mechanical ventilation as therapeutic means (ORa: 2.15; adjusted p = 0.006), SOFA score 11-14 (ORa: 2.68; p = 0.002) and organ failure (ORa: 0.08; adjusted p = 0.043). Sepsis is common in ICUs in the Republic of Congo. The profile is that of a young adult, presenting with a severe infection of digestive or neuromeningeal origin with neurological or renal failure. Mortality is high.

More from our Archive