Browsing by Author "Tang Chi Thuong"

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    Utility of SOFA score, management and outcomes of sepsis in Southeast Asia: A multinational multicenter prospective observational study
    (2018-02-14) Khie Chen Lie; Chuen Yen Lau; Nguyen Van Vinh Chau; T. Eoin West; Direk Limmathurotsakul; Pratiwi Sudarmono; Abu Tholib Aman; Mansyur Arif; Armaji Kamaludi Syarif; Herman Kosasih; Muhammad Karyana; Tawee Chotpitayasunondh; Warunee Punpanich Vandepitte; Adiratha Boonyasiri; Keswadee Lapphra; Kulkanya Chokephaibulkit; Pinyo Rattanaumpawan; Visanu Thamlikitkul; Achara Laongnualpanich; Prapit Teparrakkul; Pramot Srisamang; Phan Huu Phuc; Le Thanh Hai; Nguyen Van Kinh; Bui Duc Phu; Nguyen Thanh Hung; Tang Chi Thuong; Ha Manh Tuan; Lam Minh Yen; Nguyen Van Vinh Chau; Janjira Thaipadungpanit; Stuart Blacksell; Nicholas Day; Claire Ling; Guy Thwaites; Heiman Wertheim; Le Van Tan; Motiur Rahman; H. Rogier van Doorn; Sappasitthiprasong Hospital; Badan Penelitian Dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia; University of Indonesia, RSUPN Dr. Cipto Mangunkusumo; UCL; National Institute of Allergy and Infectious Diseases; University of Washington, Seattle; Mahidol University; Faculty of Medicine, Siriraj Hospital, Mahidol University; Queen Sirikit National Institute of Child Health; Nuffield Department of Clinical Medicine; Oxford University Clinical Research Unit; Hue Central Hospital; National Hospital of Peadiatrics; Wahidin Soedirohusodo Hospital; Shoklo Malaria Research Unit; Children's Hospital 2; Children's Hospital 1; Sardjito Hospital; National Hospital of Tropical Diseases; Chiangrai Prachanukroh Hospital; Oxford University Clinical Research Unit
    © 2018 The Author(s). Background: Sepsis is a global threat but insufficiently studied in Southeast Asia. The objective was to evaluate management, outcomes, adherence to sepsis bundles, and mortality prediction of maximum Sequential Organ Failure Assessment (SOFA) scores in patients with community-acquired sepsis in Southeast Asia. Methods: We prospectively recruited hospitalized adults within 24 h of admission with community-acquired infection at nine public hospitals in Indonesia (n=3), Thailand (n=3), and Vietnam (n=3). In patients with organ dysfunction (total SOFA score ≥2), we analyzed sepsis management and outcomes and evaluated mortality prediction of the SOFA scores. Organ failure was defined as the maximum SOFA score ≥3 for an individual organ system. Results: From December 2013 to December 2015, 454 adult patients presenting with community-acquired sepsis due to diverse etiologies were enrolled. Compliance with sepsis bundles within 24 h of admission was low: broad-spectrum antibiotics in 76% (344/454), ≥1500 mL fluid in 50% of patients with hypotension or lactate ≥4 mmol/L (115/231), and adrenergic agents in 71% of patients with hypotension (135/191). Three hundred and fifty-five patients (78%) were managed outside of ICUs. Ninety-nine patients (22%) died. Total SOFA score on admission of those who subsequently died was significantly higher than that of those who survived (6.7 vs. 4.6, p<0.001). The number of organ failures showed a significant correlation with 28-day mortality, which ranged from 7% in patients without any organ failure to 47% in those with failure of at least four organs (p<0.001). The area under the receiver operating characteristic curve of the total SOFA score for discrimination of mortality was 0.68 (95% CI 0.62-0.74). Conclusions: Community-acquired sepsis in Southeast Asia due to a variety of pathogens is usually managed outside the ICU and with poor compliance to sepsis bundles. In this population, calculation of SOFA scores is feasible and SOFA scores are associated with mortality.