Sepsis in Internal Medicine wards: current knowledge, uncertainties and new approaches for management optimization

Vincenzo Zaccone, Alberto Tosoni, Giovanna Passaro, Carla Vincenza Vallone, Michele Impagnatiello, Domenica Donatella Li Puma, Salvatore De Cosmo, Raffaele Landolfi, Antonio Mirijello, Stefano Carughi, Antonio Greco, Anthony Cossari, Francesco Malci, Giulio Ventura, on behalf of the Internal Medicine Sepsis Study Group

Research output: Contribution to journalReview articlepeer-review

Abstract

Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving. This is due to Internists’ increased adherence to guidelines and “bundles”. The routine use of SOFA score helps physicians in the definition of septic patients, even if the optimal score has still to come. Point-of-care ultrasonography, lactates, procalcitonin and beta-d-glucan are of help for treatment optimization. The purpose of this narrative review is to focus on the management of sepsis in Internal Medicine departments, particularly on crucial concepts regarding diagnosis, risk assessment and treatment.Key Messages Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. The prevalence of sepsis is constantly increasing, affecting more hospital patients than any other disease. At least half of patients affected by sepsis are admitted to Internal Medicine wards. Adherence to guidelines, routine use of clinical and lab scores and point-of-care ultrasonography are of help for early recognition of septic patients and treatment optimization.

Original languageEnglish
Pages (from-to)582-592
Number of pages11
JournalAnnals of Medicine
Volume49
Issue number7
DOIs
Publication statusPublished - Oct 3 2017

Keywords

  • Internal Medicine
  • qSOFA
  • Sepsis
  • SOFA

ASJC Scopus subject areas

  • Medicine(all)

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