CLINICAL PROFILE, MICROBIAL SPECTRUM, AND EARLY OUTCOMES IN SEPTIC SHOCK: A PROSPECTIVE OBSERVATIONAL STUDY FROM A TERTIARY CARE EMERGENCY DEPARTMENT
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Keywords
Septic shock, Emergency department, SOFA score, qSOFA score, Microbial profile, Antibiotic therapy, Patient outcomes
Abstract
Background: Septic shock remains a major contributor to emergency department (ED) mortality. Timely recognition and management are crucial to improving patient outcomes. This study aimed to assess the clinical profile, microbiological spectrum, treatment strategies, and outcomes of patients presenting with septic shock in a tertiary care ED. Methods: A prospective observational study was carried out over a one-year period in the Emergency Department of Government Medical College (GMC), Srinagar. A total of 102 adult patients diagnosed with septic shock and meeting the predefined inclusion criteria were enrolled. Comprehensive clinical and microbiological data were systematically recorded. Severity of illness was assessed using SOFA and qSOFA scores, and patient outcomes were monitored over a 72-hour follow-up period. Results: Among the 102 patients, the most affected age group was 61–70 years (31.4%), with a slight male predominance (55.9%). Fever (67.6%) and cough (54.9%) were the most common presenting symptoms. Respiratory infections were the leading cause (52%), followed by urinary tract infections (38.2%). Comorbidities included diabetes mellitus (44.4% mortality, p = 0.001) and hypertension (16.7% mortality, p = 0.006). Gram-negative organisms were isolated in 81.8% of cases, with Acinetobacter identified in 27.3%. Meropenem was the most frequently used antibiotic (43.1%). The overall mortality rate was 25.5%. Non-survivors had a significantly higher mean SOFA score on admission (12.6 vs. 9.5; p < 0.001). qSOFA score showed no statistically significant correlation with mortality (p = 0.115). Conclusion:
Septic shock in the ED is associated with substantial mortality, particularly in older adults with comorbidities. Early administration of broad-spectrum antibiotics and SOFA-based risk stratification remain critical to improving clinical outcomes.
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Dr. Judith Mattakkal Jose
Attending Consultant- Artemis Hospital, Gurgaon
Dr. Aabid Hussain Dar
Post Graduate Scholar- GMC Srinagar
Dr. Mohammad Manzar Baig
Attending Consultant- Medanta Hospital, Noida