GASTROINTESTINAL DYSFUNCTION AND HEPATIC INVOLVEMENT IN SEPSIS: CLINICAL PROFILE AND OUTCOMES IN TERTIARY CARE HOSPITALS

Abstract

Background: Sepsis is an acute organ dysfunction, a life-threatening infection, and is often associated with gastrointestinal (GI) and hepatic dysfunction. These complications contribute to poor patient outcomes, such as extended hospitalisation and increased mortality. Knowing clinical features and outcomes of sepsis in the presence of GI and hepatic dysfunction in tertiary care hospitals is essential to better manage the patients.

Objectives: To assess the clinical manifestation, data, and predictive factors of sepsis in patients with gastrointestinal dysfunction and hepatic lesions in a tertiary care hospital, with a focus on their effects on patient prognosis.

Methodology: It is a retrospective cohort study carried out in a tertiary care hospital Peshawar Pakistan. From jan 2021 to dec 2021.involved 100 sepsis patients aged 18-80 years who were admitted to the ICU. GI dysfunction (feeding intolerance, abdominal distension, ileus) and hepatic involvement (elevated liver enzymes, bilirubin levels, jaundice) data were obtained. There were records of outcomes such as length of ICU stay, complications and mortality. The statistical analysis was done with SPSS version 26.0, where descriptive statistics, Chi-square test, and regression analyses were used to find out the correlation between GI and hepatic dysfunction and patient outcomes (p<0.05).

Results: The study included 100 patients (mean age 58.2 ± 14.6 years). GI dysfunction was observed in 65% of patients, while hepatic involvement was noted in 60%. The mortality rate in patients with both GI and hepatic dysfunction was significantly higher (40%) compared to those with isolated sepsis (22%, p=0.03). Multivariate analysis revealed elevated bilirubin and severe GI dysfunction as independent predictors of mortality (p<0.05).

Conclusion: GI dysfunction and hepatic involvement are noteworthy factors associated with an unfavourable prognosis related to sepsis patients and related outcomes such as elevated mortality and extended ICU stay. Quick diagnosis and control are important to enhance the survival of patients.