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BackgroundThis study was performed to investigate the predictors of 1-year mortality at discharge in sepsis survivors. MethodsThis study was a retrospective analysis of patients with sepsis and septic shock at a single centre. Patients who survived hospitalization for sepsis or septic shock from January 2016 to December 2017 were included. Age; sex; body mass index (BMI); laboratory results such as blood cell count, C-reactive protein (CRP) and albumin; and the Sequential Organ Failure Assessment (SOFA) score at the time of discharge were compared between survivors and nonsurvivors at 1 year postdischarge. Multivariate logistic regression was performed to identify the predictors of 1-year mortality. ResultsDuring the study period, 725 survivors were included in the analysis, of whom 64 (8.8%) died within the rst year. Nonsurvivors were older and had a lower BMI and higher SOFA score at discharge than survivors (P < 0.05). Among the laboratory results at discharge, haemoglobin, platelet counts and albumin concentrations were lower in the nonsurvivors than in the survivors, whereas CRP was higher in the nonsurvivors than in the survivors. In the multivariate logistic regression analysis, serum albumin < 2.5 mg/dl and a SOFA score ≥ 2 at discharge were identi ed as independent prognostic factors for 1-year mortality (odds ratio 2.698, 95% con dential interval 1.488-4.883 for albumin < 2.5 mg/dl and 2.114, 1.204-3.814 for SOFA score ≥ 2, respectively). ConclusionsA low serum albumin concentration of < 2.5 mg/dL and high SOFA score of ≥ 2 at the time of discharge were prognostic factors for 1-year mortality in sepsis survivors.

Early and appropriate antibiotic treatment is a keystone in treating patients with sepsis. Despite its importance, blood culture which requires a few days remains as a pillar of diagnostic method for microorganisms and their antibiotic susceptibility.

Fluid resuscitation is crucial in the initial management of sepsis; however, little is known about the serial changes and overall distribution of fluids administered into the body. To identify the feasibility of longitudinal bioelectrical impedance analysis during fluid treatment, a preclinical porcine model of Escherichia coli-induced sepsis was used. After sepsis induction, pigs were treated with fluid and vasopressors and monitored for up to 12 h after bacterial infusion or until death. Bipolar electrodes for bioelectrical impedance analysis were attached to the left extremities and measurements were performed every 10 min. Among the 12 subjects, 7 pigs expired during the experiment, and the median survival was 9.5 h. As sepsis progressed with an increase in cumulative fluid balance, R0 [∝ 1/extracellular water (ECW)] decreased, while Ri [∝ 1/intracellular water (ICW)] and ratio of extracellular water to total body water (ECW/TBW) increased. The phase angle constantly decreased throughout the monitoring period, and all non-survivors died when the phase angle decreased by more than 10%. Among the variables, ΔR0 and Δphase angle showed moderate negative correlations, and ΔECW/TBW showed a moderate positive correlation with the hourly fluid balance. Compared to survivors, a greater increase in ΔECW/TBW and a decrease in phase angle were observed in non-survivors over time, with an increase in cumulative fluid balance. Differences in ΔECW/TBW and phase angle emerged at 240 min when the difference in cumulative fluid balance between the two groups (survivors vs non-survivors) exceeded 1000 mL. In conclusion, continuous measurements of bioelectrical impedance analysis in a porcine sepsis model are feasible and may reflect changes in the body water profile during fluid resuscitation.

Background This study was performed to investigate the predictors of 1-year mortality at discharge in sepsis survivors.Methods This study was a retrospective analysis of patients with sepsis and septic shock at a single centre. Patients who survived hospitalization for sepsis or septic shock from January 2016 to December 2017 were included. Age; sex; body mass index (BMI); laboratory results such as blood cell count, C-reactive protein (CRP) and albumin; and the Sequential Organ Failure Assessment (SOFA) score at the time of discharge were compared between survivors and nonsurvivors at 1 year postdischarge. Multivariate logistic regression was performed to identify the predictors of 1-year mortality.Results During the study period, 725 survivors were included in the analysis, of whom 64 (8.8%) died within the first year. Nonsurvivors were older and had a lower BMI and higher SOFA score at discharge than survivors (P < 0.05). Among the laboratory results at discharge, haemoglobin, platelet counts and albumin concentrations were lower in the nonsurvivors than in the survivors, whereas CRP was higher in the nonsurvivors than in the survivors. In the multivariate logistic regression analysis, serum albumin < 2.5 mg/dl and a SOFA score ≥ 2 at discharge were identified as independent prognostic factors for 1-year mortality (odds ratio 2.698, 95% confidential interval 1.488-4.883 for albumin < 2.5 mg/dl and 2.114, 1.204-3.814 for SOFA score ≥ 2, respectively).Conclusions A low serum albumin concentration of < 2.5 mg/dL and high SOFA score of ≥ 2 at the time of discharge were prognostic factors for 1-year mortality in sepsis survivors.