Prevalence and Factors Associated with Sepsis and Septic Shock Among ICU Patients at Adama Hospital Medical College: a Retrospective Chart Review Evaluating Outcome Predictive Performance of the Addition of Platelet Count on Modified SOFA Score

Background Sepsis and, its subset, septic shock are major health problems disproportionately affecting low- and middle-income countries. Despite the potentially high burden in low- and middle-income settings, data on prevalence and factors contributing for the development of sepsis and septic shock remains scarce. Methods A Retroactive Chart Review (RCR) was conducted on 298 patients admitted to the ICU, with the aim of identifying the prevalence and factors related to sepsis and septic shock. Coded data were transferred to and validated using Microsoft Excel, and analyzed using SPSS version 25. A binary logistic regression model was employed to identify factors contributing to sepsis and septic shock. Results Among the 298 patients, 142 (47.7%) had sepsis, and 55 (38.7% of septic patients, 18.5% of total) developed septic shock. The median age of septic patients was 40 years, and females had a higher burden of sepsis (52.8%) and septic shock (63.64%). Pneumonia was the most common site of infection (30.99% of sepsis cases). Multivariate analysis revealed that being on mechanical ventilation (AOR 5.59, 95% CI: 2.28–13.70), high white blood cell count (AOR 1.45, 95% CI: 1.00-2.12), and low platelet count (AOR 0.99, 95% CI: 0.99-1.00) were significantly associated with sepsis. Male gender (AOR 0.10, 95% CI: 0.03–0.29), high mSOFA score (AOR 1.92, 95% CI: 1.55–2.38), and low lymphocyte count (AOR 0.52, 95% CI: 0.31–0.86) were associated with septic shock. Septic shock also showed an association with low platelet count (AOR: 0.98, 95% CI: 0.98–0.99). The inclusion of platelet count in the mSOFA score resulted in a slightly higher but statistically insignificant increase in the area under the ROC curve for mortality prediction (AUC 0.832 vs. 0.826, p = 0.071). Conclusion This study found a higher prevalence of sepsis and septic shock compared to high-income countries, but comparable to most Low- and middle-income countries, and the affected population was relatively younger. Notably, despite a marginal improvement in discriminative performance, platelet count did not significantly enhance the prognostic accuracy of the mSOFA score for mortality among infection-specific ICU cohorts.