Background Sepsis-associated encephalopathy (SAE) is a common complication of sepsis that may result in worse outcomes. This study was designed to determine the epidemiology, clinical features, and risk factors of SAE. Methods This was a retrospective study of all patients with sepsis who were admitted to the Critical Care Medicine Department of Hangzhou First People’s Hospital Affiliated with Zhejiang University School of Medicine from January 2015 to December 2019. Results A total of 291 sepsis patients were screened, and 127 (43.6%) were diagnosed with SAE. There were significant differences in median age, proportion of underlying diseases such as hypertension, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, gastrointestinal infections, detection rate of Enterococcus, and 28-day mortality between the SAE and non-SAE groups. Both the SOFA score and APACHE II score were independent risk factors for SAE in patients with sepsis. All 127 SAE patients were divided into survival and non-survival groups. The age, SOFA score, and APACHE II score were independently associated with 28-day mortality in SAE patients. Conclusion In the present retrospective study, nearly half of patients with sepsis developed SAE, which was closely related to poor outcomes. Both the SOFA score and APACHE II score were independent risk factors for predicting the occurrence and adverse outcome of SAE.
Background/aim Sepsis-associated encephalopathy (SAE) is a severe complication of sepsis that affects upwards of half of all sepsis patients. Few studies have examined the etiology and risk factors of SAE among elderly patients. This study was designed to explore the epidemiology of SAE and the risk factors associated with its development in elderly populations. Materials and methods This was a retrospective analysis of elderly sepsis patients admitted to our intensive care unit between January 2017 and January 2022. We then compared non-SAE and SAE groups concerning baseline clinicopathological findings, underlying diseases, infection site, disease type, disease severity, biochemical findings, and 28-day mortality. We further stratified patients in the SAE group based on whether or not they survived for 28 days, and we compared the above data between these groups. Results Of the 222 elderly sepsis patients, 132 (59.46%) had SAE. SAE patients were found to be significantly older than non-SAE patients. Both age and blood sodium concentrations were found to be associated with SAE risk, while elderly sepsis patients without underlying chronic obstructive pulmonary disease (COPD) have a relatively higher risk of developing SAE. The SAE group also had a significantly higher rate of 28-day mortality, and sequential organ failure assessment (SOFA) scores were a risk factor associated with 28-day mortality. Conclusion Among elderly sepsis patients, SAE risk increases with advancing age, higher blood sodium concentrations, and without underlying COPD. SAE incidence is associated with a poorer prognosis, and SOFA scores are independent predictors of increased mortality among elderly SAE patients.
BackgroundThis study aimed to establish and validate an easy-to-use nomogram for predicting long-term mortality among ischemic stroke patients.MethodsAll raw data were obtained from the Medical Information Mart for Intensive Care IV database. Clinical features associated with long-term mortality (1-year mortality) among ischemic stroke patients were identified using least absolute shrinkage and selection operator regression. Then, binary logistic regression was used to construct a nomogram, the discrimination of which was evaluated by the concordance index (C-index), integrated discrimination improvement (IDI), and net reclassification index (NRI). Finally, a calibration curve and decision curve analysis (DCA) were employed to study calibration and net clinical benefit, compared to the Glasgow Coma Scale (GCS) and the commonly used disease severity scoring system.ResultsPatients who were identified with ischemic stroke were randomly assigned into developing (n = 1,443) and verification (n = 646) cohorts. The following factors were associated with 1-year mortality among ischemic stroke patients, including age on ICU admission, marital status, underlying dementia, underlying malignant cancer, underlying metastatic solid tumor, heart rate, respiratory rate, oxygen saturation, white blood cells, anion gap, mannitol injection, invasive mechanical ventilation, and GCS. The construction of the nomogram was based on the abovementioned features. The C-index of the nomogram in the developing and verification cohorts was 0.820 and 0.816, respectively. Compared with GCS and the commonly used disease severity scoring system, the IDI and NRI of the constructed nomogram had a statistically positive improvement in predicting long-term mortality in both developing and verification cohorts (all with p < 0.001). The actual mortality was consistent with the predicted mortality in the developing (p = 0.862) and verification (p = 0.568) cohorts. Our nomogram exhibited greater net clinical benefit than GCS and the commonly used disease severity scoring system.ConclusionThis proposed nomogram has good performance in predicting long-term mortality among ischemic stroke patients.
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