Main Article Content
Purpose: To investigate the prediction of nutrition status, sleep quality, the 2nd dose antibiotic timing, and blood sugar levels on sepsis in medical patients.
Design: correlational predictive design.
Methods: The sample included 126 patients aged 18 years and older, who were diagnosed of sepsis by physician or were diagnosed with 2 out of 4 symptoms of systemic inflammatory response syndrome, and were admitted to the medical ward at a tertiary hospital in Nonthaburi province between April and May 2020. The questionnaires included the demographic and history of illness recording form, Nutrition Assessment Form, Veran and Snyder-Halpern Sleep Quality Assessment, and Organ Failure Assessment score. Data were analysed by using descriptive statistics and multiple regression.
Main findings: The study findings revealed that the majority of the sample were male, (72.2%), with average age of 67.87 years. Nutritional status, sleep quality, the 2nd dose antibiotic timing and blood sugar levels could individually predict the sepsis at significance level .05 when controlling for the others. All of the study factors could together account for 56% of the variance explained in the sepsis (R2 = .56).
Conclusion and recommendations: According to the study findings, nutritional status, sleep quality, the 2nd dose antibiotic timing, and blood sugar levelshave an effect on sepsis. So, nurses should closely monitor blood sugar levels of the patients, continuously assess and promote their nutritional status and sleep quality as well as avoid the delay of 2nd dose antibiotics given to reduce sepsis and septic shock.
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
World Health Organization. Global health estimates 2016: disease burden by cause, age, sex, by country and by region, 2006-2016 [Internet]. Geneva, Switzerland; WHO; 2018 [cited 2019 Sep 7]. Available from: http://www.who.int/healthinfo/global_burden_disease/estimates/en/index1.html.
Inspection Division, Office of the Permanent Secretary, Ministry of Public Health. Ministry of Public Health Inspection plan: fiscal year 2018 [Internet]. Nonthaburi: Inspection Division, Office of the Permanent Secretary, Ministry of Public Health; 2018 [cited 2019 Sep 7]. Available from: http://data.ptho.moph.go.th/inspec/2561/inspec1/doc22dec/เอกสารประกอบการประชุม%2022-12-2560/5.%20เล่มแผนตรวจราชการ%20ปี%2061%20(รวมไฟล์ทั้งเล่ม).pdf. (in Thai).
Medical Records and Statistics Unit, Central Chest Institute of Thailand. Number of patients with sepsis who were treated in the internal medicine ward 2015-2017 [statistics]. Nonthaburi: Central Chest Institute of Thailand; 2018. 6 p. (in Thai).
Dizdar OS, Baspınar O, Kocer D, Dursun ZB, Avcı D, Karakükcü C, et al. Nutritional risk, micronutrient status and clinical outcomes: a prospective observational study in an infectious disease clinic. Nutrients. 2016;8(3):124. doi: 10.3390/nu8030124.
Claustrat B. Melatonin: biochemical, physiological and pharmacological aspects related to rhythmic phenomena and sleep. Médecine du Sommeil. 2020;17(3):177-94. doi: 10.1016/j.msom.2019.12.187.
Liu VX, Fielding-Singh V, Greene JD, Baker JM, Iwashyna TJ, Bhattacharya J, et al. The timing of early antibiotics and hospital mortality in sepsis. Am J Respir Crit Care Med. 2017;196(7):856-63. doi: 10.1164/rccm.201609-1848OC.
Mcgrade P, Yang S, Nugent K. The association between admission glucose levels and outcomes in adults admitted to a tertiary care hospital. J Community Hosp Med Perspect. 2019;9(3):195-202. doi: 10.1080/20009666.2019.1611318.
Pornsirirat T, Kusuma-naayutaya S, Pinyopasakul W, Thongyu S. Factors predicting septic shock in septicaemic medical patient. Thai Journal of Nursing Council. 2015;30(1):72-85. (in Thai).
Permpikul C. Sepsis and septic shock. Bangkok: Beyond Enterprise; 2018. 284 p. (in Thai).
Tiruvoipati R, Chiezey B, Lewis D, Ong K, Villanueva E, Haji K, et al. Stress hyperglycemia may not be harmful in critically ill patients with sepsis. J Crit Care. 2012;27(2):153-8. doi: 10.1016/j.jcrc.2011.06.011.
Komindrg S, Tangsermwong T, Janepanish P. Simplified malnutrition tool for Thai patients. Asia Pac J Clin Nutr. 2013;22(4):516-21. doi: 10.6133/apjcn.2013.22.4.06.
Yodchai K, Jitpanya C. Selected factors related to quality of sleep in hospitalized cardiac disease patients. Journal of Nursing Science Chulalongkorn University. 2006;18(2):20-32. (in Thai).
Vincent JL, de Mendonca A, Cantraine F, Moreno R, Takala J, Suter PM, et al. Use of the SOFA score to assess the incidence of organ dysfunction/failure in intensive care units: results of a multicenter, prospective study. Working group on "sepsis-related problems" of the European Society of Intensive Care Medicine. Crit Care Med. 1998;26(11):1793-800. doi: 10.1097/00003246-199811000-00016.
Chittawatanarat K, Chaiwat O, Morakul S, Kongsayreepong S. Outcomes of nutrition status assessment by Bhumibol Nutrition Triage/Nutrition Triage (BNT/NT) in multicenter THAI-SICU study. J Med Assoc Thai. 2016;99 Suppl 6:S184-92.
Routsi C, Pratikaki M, Sotiropoulou C, Platsouka E, Markaki V, Paniara O, et al. Application of the sequential organ failure assessment (SOFA) score to bacteremic ICU patients. Infection. 2007;35(4):240-4. doi: 10.1007/s15010-007-6217-6.
Hanlumyuang G. The analysis of contributing factors to septic death in Pakkred hospital. Journal of the Preventive Medicine Society of Thailand. 2020;10(1):108-17. (in Thai).
Kushimoto S, Gando S, Saitoh D, Mayumi T, Ogura H, Fujishima S, et al. The impact of body temperature abnormalities on the disease severity and outcome in patients with severe sepsis: an analysis from a multicenter, prospective survey of severe sepsis. Crit Care. 2013;17(6):R271. doi: 10.1186/cc13106.
Phillip A, Chan J, Peiris S. On long memory effects in the volatility measure of cryptocurrencies. Financ Res Lett. 2019;28:95-100. doi: 10.1016/j.frl.2018.04.003.
Han M, Fitzgerald JC, Balamuth F, Keele L, Alpern ER, Lavelle J, et al. Association of delayed antimicrobial therapy with one-year mortality in pediatric sepsis. Shock. 2017;48(1):29-35. doi: 10.1097/SHK.0000000000000833.
Charoenkul N, Siribanpitak P. An integrated performance-based budgeting model for Thai higher education. Res High Educ J. 2012;17:1-11.
Reishtein JL. Relationship between symptoms and functional performance in COPD. Res Nurs Health. 2005;28(1):39-47. doi: 10.1002/nur.20054.
Słotwinski R, Sarnecka A, Dabrowska A, Kosałka K, Wachowska E, Bałan BJ, et al. Innate immunity gene expression changes in critically ill patients with sepsis and disease-related malnutrition. Cent Eur J Immunol. 2015;40(3):311-24. doi: 10.5114/ceji.2015.54593.
Irwin MR, Opp MR. Sleep health: reciprocal regulation of sleep and innate immunity. Neuropsychopharmacology. 2017;42(1):129-55. doi: 10.1038/npp.2016.148.
Waeschle RM, Moerer O, Hilgers R, Herrmann P, Neumann P, Quintel M. The impact of the severity of sepsis on the risk of hypoglycaemia and glycaemic variability. Crit Care. 2008;12(5):R129. doi: 10.1186/cc7097.
Leisman D, Huang V, Zhou Q, Gribben J, Bianculli A, Bernshteyn M, et al. Delayed second dose antibiotics for patients admitted from the emergency department with sepsis: prevalence, risk factors, and outcomes. Crit Care Med. 2017;45(6):956-65. doi: 10.1097/CCM.0000000000002377.