SESSION TYPE: Sepsis/Shock Posters
PRESENTED ON: Wednesday, October 24, 2012 at 01:30 PM - 02:30 PM
PURPOSE: Although sepsis is one of the leading cause of mortality in hospitalized patients, information regarding early predictive factors for mortality and morbidity is limited.
METHODS: Patients fulfilling the Infectious Disease Society of America criteria of sepsis within the Medical ICU were included randomly. Apart from baseline hematological, biochemical and metabolic parameters, Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified acute physiology score II and III (SAPS II and SAPS III) and Sequential organ function assessment (SOFA) scores were calculated on day 1 of admission. Patients were followed till death or discharge from the ICU.
RESULTS: Hundred patients were enrolled over two years (54% males). The overall mortality was 53% and higher in females (69.5% vs 38.8% in males (p< 0.01). Mortality was 65.7%, 55.7% and 33.3% in patients with septic shock, severe sepsis and sepsis respectively. The mean (± SD) age was higher in patients who died (57.37 ± 20.42 years) compared to survivors (44.29±15.53 years, p < 0.01). Patient who died were significantly more anemic and had higher APACHE II, SAPS II, SAPS III and SOFA score. Presence of ARDS and renal dysfunction were associated with higher mortality (75% and 70.2% respectively). There was no significant difference in the median duration of mechanical ventilation or ICU stay between survivors and non-survivors. On multivariate analysis, significant predictors of mortality with Odds’ ratio greater than 2 included the presence of anemia, SAPS II score greater than 35, SAPS III score greater than 47 and SOFA score greater than 6 at day 1 of admission.
CONCLUSIONS: Several demographic and laboratory parameters as well as composite critical illness scoring systems are reliable early predictors of mortality in patients with sepsis.
CLINICAL IMPLICATIONS: Routine use of critical illness scoring systems may provide useful prognostic information in patient with sepsis
DISCLOSURE: The following authors have nothing to disclose: Prajowl Shrestha, Anant Mohan, Surendra Sharma, Randeep Guleria, Naval Vikram, Naveet Wig, Ravindra Pandey
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