Overdiagnosis of Septic Shock and Loss of Potential Donors of Corneal Tissue in the Hospital General de México Dr. Eduardo Liceaga.

At the Hospital General de México Dr. Eduardo Liceaga, a large number of potential donors of corneal tissue are discarded owing to various contraindications such as shock septic. The objective of this study is to determine the number of patients with postmortem diagnosis of septic shock and analyze whether there is an overdiagnosis of it. It is a cross-sectional and descriptive study in which 144 (n = 144) medical records were reviewed between January 2018 and May 2019 and where septic shock was identified within postmortem diagnoses. Exclusion criteria were age <2 or ≥75 years; infection due to human immunodeficiency virus, hepatitis B virus, or hepatitis C virus; active tuberculosis; neuroinfection; endocarditis; or cancer. The Sequential Organ Failure Assessment (SOFA) scale was calculated, and a descriptive analysis of the data was performed. According to the third international consensus for the definition of sepsis and septic shock (SEPSIS 3) using its SOFA diagnostic tool, 46 (32%) patients did not meet the criteria for septic shock because they did not require vasopressor nor had a lactate ≥ 18 mg/dL. These were potential donors of corneal tissue that were not considered as such; 35 of them met the diagnosis of sepsis with SOFA scores of ≥2 and the suspected or documented presence of infection. Eleven patients were not considered septic. It is important to train the hospital medical staff to properly diagnose septic shock, based on international consensus, and perform all the laboratory studies that allow doctors to calculate the SOFA to confirm or rule out the presence of septic shock.