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Predictors of mortality in patients with severe sepsis admitted to an ICU
Critical Care volume 17, Article number: P46 (2013)
Severe sepsis is an important cause of morbidity and mortality for patients in ICUs . Since instituting rapid treatment for patients with sepsis is critical, the need for reliable predictors of mortality to guide therapy is evident. This study attempts to identify the risk factors for mortality in patients admitted with severe sepsis to the ICU.
Materials and methods
Case-control study conducted in the ICU of Hospital Anchieta, Brasília, DF, Brazil, during 5 months. Patients were divided into two groups: survivors group (SG) and nonsurvivors group (NSG).
During the study, 38 patients were admitted with severe sepsis, with a mortality rate of 47% (n = 18). Upon admission, the patients in the NSG presented higher values of: SAPS3 score (82 ± 12 vs. 60 ± 14, P = 0.00), heart rate (119 ± 21 vs. 99 ± 15 bpm, P = 0.00), serum creatinine (2.4 ± 1.4 vs. 1.5 ± 0.9 mg/dl, P = 0.00), decreased level of consciousness (92% vs. 58%, P = 0.03), need for vasopressor (85% vs. 25%, P = 0.00), need for invasive mechanical ventilation (62% vs. 12%, P = 0.00) and previous cardiac arrest (15% vs. 0%, P = 0.00). The platelet count was lower in the NSG (119,000 ± 70,000 vs. 220,000 ± 103.000/mm3, P = 0.00). There was no significant difference between the groups regarding the following factors: age (65 ± 19 vs. 65 ± 19 years, P = 0.98), respiratory rate (29 ± 9 vs. 26 ± 7 rpm, P = 0.30), axillary temperature (36.9 ± 0.7 vs. 37.2 ± 1.8°C, P = 0.43), leukocyte count (17,500 ± 7,800 vs. 13,000 ± 6.000/mm3, P = 0.08), immunosuppression (38.5% vs. 12.5%, P = 0.07), and prior use of corticosteroids (23% vs. 25%, P = 0.90).
SAPS3 score, metastatic cancer, decreased level of consciousness, need for vasopressors, invasive mechanical ventilation, previous cardiac arrest, heart rate, serum creatinine, and platelet count were associated with mortality in severe sepsis for this sample of patients.
Marshall JC, Vincent JL, Guyatt G, Angus DC, Abraham E, Bernard G, Bombardier C, Calandra T, Jørgensen HS, Sylvester R, Boers M: Outcome measures for clinical research in sepsis: a report of the 2nd Cambridge Colloquium of the International Sepsis Forum. Crit Care Med. 2005, 33: 1708-1716. 10.1097/01.CCM.0000174478.70338.03.
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Araújo, F.V.B., Amorim, F.F., Santana, A.R. et al. Predictors of mortality in patients with severe sepsis admitted to an ICU. Crit Care 17 (Suppl 4), P46 (2013). https://doi.org/10.1186/cc12946
- Heart Rate
- Serum Creatinine
- Platelet Count