Determination of Factors Affecting Mortality of Patients with Sepsis in a Tertiary Intensive Care Unit

Abstract

OBJECTIVES:Sepsis is a disease with high mortality that is frequently observed in intensive care units. This study aimed to determine the risk factors affecting mortality of patients with sepsis who were followed up in the intensive care unit (ICU). We aimed to contribute to literature by evaluating the relationship between mortality and pro-brain natriuretic peptide (pro-BNP9), C-reactive protein (CRP), thrombocyte count, Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, duration of hospitalization in the intensive care unit, and the presence of multidrug-resistant microorganism. MATERIAL AND METHODS:Patients hospitalized in ICU because of the diagnosis of sepsis and septic shock between December 2010 and June 2012 were included in this retrospective study. RESULTS:A total of 141 patients, including 74 male (52.5%) and 67 female (47.5%) patients, were involved in the study, and the median age was 66.8±17.9 years. Sixty-nine patients (48.9%) were discharged from the ICU; however, 72 patients (51.1%) were exitus. Multidrug-resistant microorganism was detected in 34 patients (24.1%). The patients' median SOFA score was 9.16±3.16, median APACHE-II score was 24.9±7.83, and median duration of hospitalization in the ICU was 8.44±11.61 days. It was found that mortality rate significantly increased in patients with the APACHE-II score of 24.5 and over, SOFA score of 8.5 and over, pro BNP value of 7241 ng/L and over, and CRP value of 96.5 mg/dL and over. Mortality rate was detected to be higher in patients undergoing invasive mechanical ventilation than in patients undergoing non-invasive mechanical ventilation. When thrombocyte count and mortality were associated with each other, it was found that the median value was 86000 mg/dL in exitus patients, whereas it was 185000 mg/dL in patients discharged from the ICU. CONCLUSION:It was revealed that increased APACHE-II score, increased SOFA score, increased pro BNP score, increased CRP, the presence of multidrug-resistant microorganism, and decreased thrombocyte count elevated the rate of mortality. However, no relationship was observed between the duration of hospitalization in the ICU and mortality.

The Epidemiology, Therapeutic Patterns, Outcome, and Challenges in Managing Septic Shock in a Sub-Saharan African Intensive Care Unit: A CrossSectional Study

“…The current findings confirm the common risk factors associated with mortality in the literature. 2,11,21 In contrast to a French study 21 and a multinational study 11 which found older age (age ≥65 years) to be a significant risk factor for SS-related mortality, it was observed in this study that being an infant was instead a risk factor, probably explained by the immature immunity of infants. 26 Similar to previous studies, [27][28][29] a low GCS was found in this study to be associated with mortality in patients with SS.…”

“…Previous studies have shown that a decreased SOFA score is known to be predictive of decreased mortality, while an increased SOFA score is indicative of increased mortality. 2,23 In contrast, an increase in SOFA score was not found to be associated with mortality in the present study. The majority of SS cases were hospital-acquired, corroborating with the results of Baharoon et al on the epidemiology of sepsis in an tertiary ICU of Saudi Arabia.…”

“…The mean duration of ICU stay was 3.5 ± 3.1 days, drastically lower than the 8.44 ± 11.61 days observed in Turkey. 2 This may reflect the differences in the health infrastructure and equipment between the Turkish and Cameroonian health systems, with better management of this pathology in Turkey and more Turkish SS patients living longer. It may also reflect more virulent bacteria in the hospital ecology responsible for shorter hospital stays and a higher in-ICU mortality rate in the milieu of the current study compared with Turkey.…”

“…1 Patients with SS have an inadequate blood supply perfused to noble organs, resulting in coma, strokes, myocardial infarction, acute kidney injury, or multi-organ dysfunction and ultimately death if resuscitation is not performed in a timely manner. 2,3 Survivors of SS are at an increased risk of reduced quality of life due to long-term physical, cognitive, and psychological dysfunction, 4,5 as well as death within a year following primary care and emergency departments pivotal points to improving recognition and early management. However, when the infection is overwhelming, it often becomes a SS necessitating intensivists and intensive care unit (ICU) admission for optimal care.…”

Platelet to lymphocyte and neutrophil to lymphocyte ratios as strong predictors of mortality in intensive care population

“…Since mortality and morbidity rates are much higher in the ICU population compared to other patients who do not require treatment in ICU, surrogate markers for predicting mortality in ICU subjects have been established. C-reactive protein (CRP) is one of these markers and usually increases in conditions associated with inflammation or infection 1 .…”