SESSION TITLE: Sepsis and Shock Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM
PURPOSE: Severe sepsis is an excessive systemic inflammatory response to infection, associated with high mortality. Septic patients often have pre-existing medical conditions. Pulmonary arterial hypertension (PAH) is characterized by chronic high pressure in the pulmonary circuit with right heart failure. We tested the hypothesis that patients with PAH who develop severe sepsis have prolonged recovery times and higher mortality, compared with the general population of septic patients.
METHODS: We performed a retrospective cohort study comparing the two groups of patients admitted to University of Kansas Hospital (KUH) between 3/2008 and 3/2012. Data were extracted using HERON, a local instantiation of i2b2 modified for in-patient searches and linked to the KUH EMR. Data were analyzed via Fisher’s Exact Test for proportional data and Student’s t-test for continuous data.
RESULTS: 45 of 263 (17%) admitted PAH patients had simultaneous sepsis, compared with 3,647 septic inpatients of 61,741 (5.9%) non-PAH admissions (p<0.0001). The in-hospital mortality rate for PAH-sepsis was 35.6% vs. 23.9% for non-PAH-sepsis (p=0.101). The hospital length of stay (LOS) was 9.2 ± 0.67 days (mean ± SEM) for PAH-sepsis patients, vs. 6.8 ± 0.11 days for non-PAH-sepsis (p=0.0013). The ICU-LOS was 6.4 ± 0.69 days for PAH-sepsis patients, vs. 3.0 ± 0.08 days for non-PAH-sepsis (p<0.0001 for ICU-LOS). 22.2% of PAH-sepsis patients were discharged to a nursing home, compared with 14.9% of non-PAH-sepsis patients (p=0.08).
CONCLUSIONS: Septic patients with PAH require longer hospital LOS and ICU LOS compared with non-PAH patients with severe sepsis. Septic PAH is associated with higher mortality and a greater risk of nursing home placement compared with non-PAH sepsis.
CLINICAL IMPLICATIONS: Patients with PAH may be at greater risk of developing severe sepsis than non-PAH patients. Septic PAH patients experience prolonged recovery times in comparison with non-PAH septic patients and consume more healthcare resources.
DISCLOSURE: Lewis Satterwhite: Grant monies (from industry related sources): PI for PAH study Ikaria Pharmaceuticals The following authors have nothing to disclose: Steven Simpson, Monica Johnson, Lemuel Waitman
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