sepsis criteria and revision in toxicological intensive care unit

Background: sepsis is one of the significant causes of mortality in hospitalized patients. thiscross-sectional study was performed to determine the frequency of positive blood cultureand assess sepsis criteria based on third international consensus definitions (related tosequential organ failure assessment score) and clinical and paraclinical findings (i.e., onadmissionleukocytosis, increased lactate level, and fever) in poisoned patients admitted to thetoxicological intensive care unit (ticu).methods: medical records of a total of 2000 poisoned patients admitted to the ticu ofloghman hakim hospital from 2016 to 2018 were assessed. among them, 189 cases (9.45%)with suspected sepsis were considered eligible to be enrolled in the study.results: of 189 cases, 146 (77.24%) had possible signs and symptoms of sepsis as well assofa score higher than two with positive blood culture in 81 cases (55%). the mean±sdserum level of lactate was 25.97±16.32 on admission. the most common pathogen detected inblood culture was coagulase-negative staphylococci in 35 (24.0%) out of 146 cases. glasgowcoma scale (gcs) less than 12, age older than 50 years, and bilirubin more than 1.2 mg/dlwere found as independent predictors of sepsis on multivariate analysis.conclusion: based on our findings, it is proposed that the sepsis definition should not berestricted to the guidelines. the patients’ poisoning background and presence of manyconfounding factors, including poisoning-induced on-admission increased lactate levels,leukocytosis, and disturbed arterial blood gas provide a critical decision-making situation toconfirm sepsis according to guidelines.