Razi Journal of Medical Sciences

    Background & Aim: Diabetes mellitus is one of the commonest chronic diseases in community which induces immunodeficiency and infection through multiple mechanisms. In addition, infections can also bring about hyperglycemia and ketoacidosis. In this study, we have tried to evaluate the frequency of diabetes and the factors related to its outcome in patients with sepsis. Patients & Method: This is a descriptive cross-sectional study which involves 300 randomly sampled cases who had been admitted to Rasoul-e-Akram Hospital and diagnosed with sepsis between 2001 and 2003. The data was analyzed by SPSS version 11.5. Results: The mean age of the patients was 52.7 years(SD=28.4). 158(52.7%) out of 300 patients had diabetes. The most common sites of infection were respiratory tract and then urinary tract. Evaluation of the outcome of the patients in two diabetic and non-diabetic groups demonstrated a statistical difference(P.value=0.001). Mortality rate increased with aging and delay in beginning the treatment(P.value=0.001). With respect to 4 signs of SIRS, 88 cases revealed 2, 156 had 3, and 56 presented with all signs at the time of admission. 16(18.2%) of the first group, 116(74.4%) of the second group, and 47(84%) of the third group expired, though(P.value=0.001). Of 158 patients with diabetes, 67 cases of whom 97% expired had average blood glucose more than 250mg/dl, 55 ones of whom 84% expired had average blood glucose between 180-250 mg/dl, and 36 patients of whom 42% expired had average blood glucose less than 180 mg/dl. These 3 groups, however, demonstrated statistical differences(P.value=0.001). Conclusion: This study demonstrates that aging can increase the rate of sepsis and its mortality in both diabetic and non-diabetic groups. Also, mortality of sepsis in diabetics is more than non-diabetics and quick treatment of it can decrease this mortality. In addition, mortality increases with an increase in the severity of the disease, i.e. more SIRS criteria, and strict control of blood glucose can result in a better prognosis.