• Murillo Assunção, Nelson Akamine, Guttemberg S Cardoso, Patricia V C Mello, José Mário M Teles, André Luis B Nunes, Marcelo Oliveira Maia, Alvaro Rea-Neto, Flavia Ribeiro Machado, and SEPSES Study Group.
• Disciplina de Anestesiologia, Dor e Terapia Intensiva. Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil. murilloassuncao@gmail.com
• J Crit Care. 2010 Dec 1;25(4):545-52.

PurposeIn Brazil, sepsis has a high mortality; and early recognition is essential in outcome. The aim of the study was to evaluate physicians' knowledge about systemic inflammatory response syndrome (SIRS), sepsis, severe sepsis, and septic shock concepts.MethodsThis was a prospective, observational study performed in 21 hospitals in Brazil, which enrolled physicians working in the participant institutions. A previously validated questionnaire was applied to physicians including 5 clinical cases.ResultsTwenty-one Brazilian institutions enrolled 917 physicians. The percentage of physicians correctly recognizing SIRS, infection, sepsis, severe sepsis, and septic shock was 78.2%, 92.6%, 27.3%, 56.7%, and 81.0%, respectively. Intensivists performed better in all diagnoses. There was a significantly higher rate of correct answers for SIRS (P < .001), sepsis (P = .001), and severe sepsis (P = .032) among physicians from university hospitals as compared with those from public hospitals. A mean global score of 3.36 ± 1.08 was found, with better performance for residents (P = .012) and intensivists (P < .001); but no difference was found for emergency physicians (P = .875).ConclusionThe prompt recognition of sepsis and its severity is not satisfactory. This difference is probably due to the difficulty in the recognition of organ dysfunction, which hampers early identification of septic patients.Crown Copyright © 2010. Published by Elsevier Inc. All rights reserved.

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