Philadelphia, USA: Sepsis, a life-threatening condition caused by the body’s response to an infection, is one of the most frequent causes of death in the hospital and one of the most expensive conditions to treat.
The researchers from Drexel University identified the specific symptoms that put patients at the greatest risk of dying from sepsis using patient records from 210,289 hospital visits between 2013 and 2016.
Muge Capan and associates conducted a retrospective data analysis to quantify the impact of organ dysfunction on in-hospital mortality in the infected population. The study was published in the journal Critical Care.
The study showed that impaired kidney function is one of the leading predictors of sepsis patient mortality. Moreover, the researchers found that the more well-known symptoms of sepsis, such as low blood pressure, were linked to lower mortality rates in the population they studied
“We now have large-scale evidence that many of these organ system failures that are typically underappreciated – particularly the renal and respiratory systems – actually have the highest association with death,” said study co-principal investigator Ryan Arnold, MD, an emergency medicine doctor and faculty member at Drexel College of Medicine.
“That likely speaks more to the health care providers’ response to the symptom, than the low blood pressure itself actually being a protective factor,” Arnold added. “With sepsis, patients generally don’t fall off of a cliff. Instead, it’s a day by day, gradual deterioration. Maybe someone has a small increase in creatinine today, and tomorrow it’s a little worse. Those subtle changes that don’t get detected, we found, lead to death.”
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Of the 210,289 visits during the study period, 62,057 patients (30 per cent) were treated for an infection, and 48,680 (78 per cent) experienced organ dysfunction. Of the patients treated for an infection, 1,955 (3 per cent) died during this period. Patients with worsening kidney function (increase in creatinine levels by 50 per cent from baseline) had the highest mortality rate (17 per cent), followed by mechanical ventilation requirement (13 per cent).
Patients with hypotension had the lowest incidents of death. The researchers also found that treating patients for an infection within 24 hours of being admitted to the hospital significantly lowered their risk of dying.
The study would help in developing a clinical decision support system that can give providers real-time alerts about patients that might be at high risk for dying from sepsis.
For full information log on to https://doi.org/10.1016/j.jcrc.2018.08.021