Sepse em idoso com pneumonia adquirida na comunidade: critérios diagnósticos e propostas de protocolo para identificação e início precoce de tratamento

Abstract

Introduction: Community-acquired pneumonia (CAP) still remains the infectious disease of greatest social medical impact on morbidity and treatment-related costs, and sepsis is a serious and often fatal complication of this condition. Objectives: To verify the occurrence of sepsis from CAP in elderly admitted to an emergency room and to evaluate the application of prognostic indices PSI, CURB 65 and qSOFA in the definition of this clinical evolution. Methods: Quantitative, observational and longitudinal study conducted in the emergency room of a public hospital in the Federal District with patients over 60 years hospitalized and diagnosed with CAP. They were followed for a period of 10 days to verify the occurrence of sepsis, based on the international consensus 2012 and 2016. Results: Of the 47 elderly with CAP followed, 95.7% (n = 45) were described with sepsis according to the 2012 Consensus, while according to the 2016 Consensus, 74.4% (n = 35) reported sepsis. such a disease. The PSI, CURB, positive qSOFA indices (p-value: <0.01; 0.02; 0.015, respectively) were statistically associated with sepsis. Age was also identified as an independent factor for sepsis (p-value: 0.043). Death occurred in 21.2% (n = 10) of the patients. Product: Development of protocol for identification and early initiation of sepsis treatment in an elderly patient. Conclusion: The occurrence of sepsis is common in hospitalized elderly patients with CAP. The application of severity indices in CAP is an important care tool.