Sepsis and Septic Shock in the Emergency Departments of Mexico: Multicentric, Point-Prevalences Study

Background: Sepsis is an emergency, therefore one of the main causes of consultation in the Emergency Departments (ED); In this study we estimate the prevalence, resuscitation measures and mortality of patients with sepsis and septic shock in the ED of Mexico. Method: We conducted a 1-day point-prevalence study, with nonrandomized sampling, where ED was invited to participate in Mexico freely, obtaining participation from 68 hospitals, with 30-day follow-up to ED patients with diagnosis of sepsis or septic shock according to Sepsis-3; We analyzed the demographic, management and outcome variables with Mann Whitney U, X2, Fisher exact test, OR and 95% CI, Spearman correlation, according to the type of data, the results were significant when the p <0.05. Findings: On September 13, 2017, 68 ED attended 2379 patients, of whom 307 had sepsis and 41 (13.35% of those included) had septic shock, the prevalence of sepsis was 12.9% (95% CI 11.62 - 14.31% ), with overall mortality of 16.93% (95% CI 13.02 - 20.85%), with mortality in sepsis 9.39% (n = 25, 95% CI 8.12 - 10.68%) and in septic shock 65.85% (n = 34, 95% CI 53.60-77.17%); we did not find significant differences in the demographic variables or the type of hospital; We observed that fluid balance in the first 3 hours was higher in those who died (10.68 vs 17.44 mL/kg, p = 0.0271), we also note an important lack of adherence to the national and international recommendations for initial resuscitation. Interpretation: we found a high prevalence of sepsis in Mexican EDs, with a mortality of septic shock similar or even higher than that reported internationally, associated with the lack of resources and the saturation of ED, among other determinants, which highlights the need for updating and training programs to improve the quality of care and the prognosis of patients. Financing Statement: Fundacion Sepsis Mexico. Declaration of Interests: The authors declare no competing interests. FSM sponsored digital resources for the registration of collaborators and data collection. Ethics Approval Statement: The study was approved by the Research Committee and the Research Ethics Committee of Hospital Juarez de Mexico with registration HJM 0515/18-I, due to the type of study, no informed consent was required. For the preparation of this report, the EQUATOR guide was used with STROBE checklist (20).