The long-term burden of severe sepsis and septic shock

Guirgis, Faheem W.; Brakenridge, Scott C.; Sutchu, Selina; Khadpe, Jay; Robinson, Taylor; Westenbarger, Richard; Topp, Stephen T.; Kalynych, Colleen; Reynolds, James M.; Dodani, Sunita; Moore, Frederick A.; Jones, Alan E.

doi:10.1097/ta.0000000000001135

Cited by 45 publications

(44 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results indicate the mSOFA score is also a guide to mortality following hospital discharge, reaching 25% and 38.6% at 30 and 90 days, respectively. Mortality occurs both from underlying chronic disease and disability, and prolonged physiological effects of sepsis such as persistent activation of the inflammatory and coagulation systems, cellular immune dysfunction and increased rates of acute coronary events …”

Section: Discussionmentioning

confidence: 99%

Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective assessment of prognostic value

Raymond

Nguyen

Allmark³

et al. 2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective assessment of prognostic value

Raymond

Nguyen

Allmark³

et al. 2018

Emerg Medicine Australasia

View full text Add to dashboard Cite

show abstract

“…Most research regarding organ failure are on selected patient groups in the ED1–5 or in the post ED period 6 7. These studies find that organ failure is a frequent potential critical condition, with a high mortality.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study

et al. 2019

View full text Add to dashboard Cite

ObjectivesThe aim was to describe population-based incidence and emergency department-based prevalence and 1-year all-cause mortality of patients with new organ failure present at arrival.DesignThis was a population-based cohort study of all citizens in four municipalities (population of 230 000 adults).SettingEmergency department at Odense University Hospital, Denmark.ParticipantsWe included all adult patients who arrived from 1 April 2012 to 31 March 2015.Primary and secondary outcome measuresOrgan failure was defined as a modified Sequential Organ Failure Assessment score≥2 within six possible organ systems: cerebral, circulatory, renal, respiratory, hepatic and coagulation.The primary outcome was prevalence of organ failure, and secondary outcomes were 0–7 days, 8–30 days and 31–365 days all-cause mortality.ResultsWe identified in total 175 278 contacts, of which 70 399 contacts were further evaluated for organ failure. Fifty-two per cent of these were women, median age 62 (IQR 42–77) years. The incidence of new organ failure was 1342/100 000 person-years, corresponding to 5.2% of all emergency department contacts.The 0–7-day, 8–30-day and 31–365-day mortality was 11.0% (95% CI: 10.2% to 11.8%), 5.6% (95% CI: 5.1% to 6.2%) and 13.2% (95% CI: 12.3% to 14.1%), respectively, if the patient had one or more new organ failures at first contact in the observation period, compared with 1.4% (95% CI: 1.3% to 1.6%), 1.2% (95% CI: 1.1% to 1.3%) and 5.2% (95% CI: 5.0% to 5.4%) for patients without. Seven-day mortality ranged from hepatic failure, 6.5% (95% CI: 4.9% to 8.6%), to cerebral failure, 33.8% (95% CI: 31.0% to 36.8%), the 8–30-day mortality ranged from cerebral failure, 3.9% (95% CI: 2.8% to 5.3%), to hepatic failure, 8.6% (95% CI: 6.6% to 10.8%) and 31–365-day mortality ranged from cerebral failure, 9.3% (95% CI: 7.6% to 11.2%), to renal failure, 18.2% (95% CI: 15.5% to 21.1%).ConclusionsThe study revealed an incidence of new organ failure at 1342/100 000 person-years and a prevalence of 5.2% of all emergency department contacts. One-year all-cause mortality was 29.8% among organ failure patients.

show abstract

“…The choice of this composite adverse outcome is reflective of the fact that patients who initially survive their sepsis admission may experience poor outcomes other than in-hospital death, which may be characterized by physical dependence and reduced quality of life, or death soon after discharge from the hospital. 20 We hypothesize that Dys-HDL will be present early after sepsis and that early changes in Dys-HDL will be predictive of adverse outcomes and potentially correlate with changes in cytokine levels. If these associations can be proven, we believe that a foundation for further investigations of Dys-HDL as a sepsis biomarker may be established.…”

Section: Introductionmentioning

confidence: 99%

Exploring the Predictive Ability of Dysfunctional High-Density Lipoprotein for Adverse Outcomes in Emergency Department Patients with Sepsis: A Preliminary Investigation

Guirgis

Dodani

Moldawer

et al. 2017

Shock

Self Cite

View full text Add to dashboard Cite

Background High Density Lipoprotein (HDL) can be readily oxidized in inflammatory conditions and exhibit pro-inflammatory and dysfunctional (Dys-HDL) characteristics. We hypothesize that Dys-HDL may predict adverse outcomes and correlate with inflammatory cytokines in sepsis. Methods Emergency department (ED) patients with sepsis were enrolled. Blood was drawn at enrollment and after 48 hours. Dys-HDL, expressed as HDL inflammatory index (HII), and cytokines were measured. Multivariable logistic regression was used to determine the predictive ability of Dys-HDL for adverse outcomes (death, discharge to hospice or nursing home). Results Thirty five patients were included in the study. HII was not significantly different at baseline or 48 hours between patients with adverse outcomes versus those without. However, there was a significant difference in change in HII over the first 48 hours between those with adverse outcomes (+0.21, 95% CI −0.13 – 0.31) versus those without (−0.11, 95% CI −1 – 0.11) (p = .025). Logistic regression revealed increasing HII to be an independent predictor of adverse outcomes (OR 5.2, 95% CI 1.1–25.1 p = 0.040). Of the 24 patents with cytokine measurements at both time points, significant inverse correlations between change in HII and change in GRO (rs = −.52, p = .0088) and MCP-1 (rs = −.61, p = .0014) concentrations over 48 hours were observed. Conclusion Increasing Dys-HDL concentrations in the first 48 hours of sepsis are associated with an ongoing inflammatory response and adverse clinical outcomes. Early changes in HII may be a potential biomarker in ED patients admitted with sepsis.

show abstract

The long-term burden of severe sepsis and septic shock

Abstract: Prognostic/epidemiologic study, level IV.

Cited by 45 publications

References 23 publications

Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective assessment of prognostic value

Modified Sequential Organ Failure Assessment sepsis score in an emergency department setting: Retrospective assessment of prognostic value

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study

Exploring the Predictive Ability of Dysfunctional High-Density Lipoprotein for Adverse Outcomes in Emergency Department Patients with Sepsis: A Preliminary Investigation

Contact Info

Product

Resources

About