Introduction

The aim of this study was evaluation of physicians' knowledge about SIRS, sepsis, severe sepsis and septic shock.

Methods

A multicenter study in 21 ICUs in seven university, five public and seven private hospitals. A questionnaire with five clinical cases was first validated by five critical care boarded intensivists (INT) with 100% agreement. All interviewed physicians (Phys) received each question separately, in a predefined sequence, and no answer could be reviewed. After answering, the questionnaire was put in a sealed envelope with no identification. Statistical analysis was performed: chi-square, Kruskall–Wallis and linear correlation tests. P < 0.05 was considered statistically significant.

Results

A total of 917 Phys (mean age 32.7 ± 7.21 years, 61.9% males, 38.1% females) were enrolled with 20.0% (n = 55) INT and 80.0% (n = 220) of nonintensivists (non-INT). Phys correctly recognized SIRS, infection, and septic shock in 80.4%, 92.4% and 85.1% of the cases, respectively. The lowest rate of recognition was observed in sepsis and severe sepsis cases (26.5% and 55.6%). Considering all questions, the overall percentage of correct answers was 68.1 ± 21.1%. INT performed better than non-INT (84.7 ± 17.2% and 64.0 ± 20.0%, P < 0.00001). Phys working at public and university hospitals performed better (70.2 ± 18.7% and 71.2 ± 19.5%) than those in private hospitals (59.7 ± 23.4%, P = 0.001).

Conclusion

The recognition of sepsis and its severity are not satisfactory, mostly among non-INT and those working at private hospitals. Possibly, reviewing sepsis-related and organ dysfunction concepts are necessary for early identification of septic patients.