Outcomes of using the MEWS (SOS Score) that affected the severe sepsis and septic shock in sepsis patients at Medical Department, Udonthani hospital

Abstract

Background: Sepsis was the highest caused of death at medical department. During the fiscal year 2011 to 2014, the mortality rates were 26.7%, 25.6%, 18.9% and 22.0% respectively. In 2013, 30% of sepsis patients turned to severe sepsis and septic shock.

Objective: To analyze the outcomes of using the Modified Early Warning Score (MEWS); SOS Score and factors that affected to severe sepsis and septic shock in sepsis patients at medical department, Udonthani hospital.

Method: It was an analytical study. The samples consisted of the patients who meet at least two criteria of Systemic inflammatory response syndrome (SIRS) between 1st June to 31st July 2015. By purposive sampling, 205 sepsis patients was recruited. The research instruments consisted of 1) practical guidelines of SOS Score 2) data collection tools which were composed of the questionnaire and observation forms about sepsis condition, severe sepsis and septic shock. The data were analyzed on SPSS program by using descriptive statistics and Fisher’s exact test with confidence level 0.05.

Results: Male 51.2%, mean age 57 year olds, Abnormal SIRS criteria; body temperature, pulse, respiratory rate and white blood cell count were 97.6, 83.9, 33.2 and 42.0% respectively. Source of infection was lung (Pneumonia) and Urinary tract 41 and 15.1% respectively. Comorbidity were Diabetes and Chronic kidney disease 34.1 and 18.0 % respectively and Follow SOS Score practical guideline 55.6%. There was 12.2% of the samples turned to severe sepsis and septic shock. The correlation between the factors that affect to severe sepsis and septic shock in sepsis patients were personnel compliance of SOS score guidelines and sepsis in diabetes mellitus patients was statistically significant correlation of severe sepsis and septic shock. The other factors were not shown statistically significant correlation.

Conclusions: Medical workers should be encourage to use SOS Score guidelines continuously and regularly. Sepsis patients with diabetes mellitus, fever >38^o or < 36^o Celsius and heart rate >90 beats/minute should be closely observed by using MEWS guidelines to prevent the sepsis patients from turning to severe sepsis and septic shock.