19. CONCLUSIONI
1. La sepsi continua ad essere una patologia molto frequente, nonché la causa più frequenti di ricovero in terapia intensiva e di morte tra la popolazione adulta nei paesi occidentali, i tassi di mortalità della sepsi grave e shock settico sono 30 al 70%, la sindrome di disfunzione d’organo è frequente nelle UTI con una incidenza del 40%, il 57% di questi paziente già lo presentano al inizio del suo ricovero .
2. È importante segnalare che l’ introduzione del concetto Early goal directed therapy per la sepsi come una terapia standardizzata, a dimostrato come essa riduca la mortalità della sepsi grave e dello shock settico in maniera consistente e le linee guida supportano l’utilizzo del protocollo di controllo poiché la qualità di vita si considera un rilevante indice di pronostico in UTI anche se non esistono studi sufficenti sui pazienti critici. 3. Nonostante i progressi nella fisiopatologia della sepsi, pubblicati negli ultimi decenni, la sepsi ha un enorme impatto economico che comporta che la morbilità e la mortalità rimangono elevati. La sepsi, e più in particolare le sue forme più gravi, rimane una delle malattie più diffuse in terapia intensiva con un aumento della sua incidenza annuale. Questo potrebbe essere spiegato con il progressivo cambiamento di criteri di ingresso (di età superiore o pazienti immunocompromessi) per l’avanzamento tecnologico ed l’uso delle risorse per supportare la disfunzione d’organo.
4.. Le figure professionali, i programmi di sistema di sorveglianza e costo economico nell’ambito della prevenzione della sepsi, rivestono un ruolo cardine, non solo come ottimizzazione nella pratica medica, anche nell’implementazione della ricerca, e nell’implementazione di protocolli validati e adeguati alle circostanze locali, che devono essere valutati in modo permanente, coinvolgendo tutta la sanità.
5. Per la sepsi, e le sue forme più gravi, ad oggi non esiste una classificazione unica per inglobare questo fenomeno dovuto a che ogni episodio ha un comportamento diverso in ogni paziente, e conoscendo ognuno di loro, questo ci permetterà di dirigere la terapeutica a seconda delle particolari caratteristiche del paziente.
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