Prognostic factors in the first hour post admission for intra-hospital mortality in patients with septic shock in an ICU
- Bárbara Magalhães Menezes1,
- Fernanda Vilas Bôas Araújo1,
- Fábio Ferreira Amorim1,
- Adriell Ramalho Santana1,
- Felipe Bozi Soares1,
- Jacqueline Lima de Souza1,
- Mariana Pinheiro Barbosa de Araújo1,
- Louise Cristhine de Carvalho Santos1,
- Pedro Henrique Gomes Rocha1,
- Mateus Gonçalves Gomes1,
- Osvaldo Gonçalves da Silva Neto1,
- Pedro Nery Ferreira Júnior1,
- Alethea Patrícia Pontes Amorim2,
- Rodrigo Santos Biondi3 and
- Rubens Antônio Bento Ribeiro3
© Menezes et al.; licensee BioMed Central Ltd. 2013
Published: 5 November 2013
Severe sepsis and septic shock are common and are associated with substantial mortality and substantial consumption of healthcare resources . Although the incidence of septic shock has steadily increased during the past several decades, the associated mortality rates have remained constant or have decreased only slightly . Our study aimed to identify the prognostic factors during the first hour after admission for intra-hospital mortality in patients with septic shock in a general ICU.
Materials and methods
Case-control study conducted on patients admitted to the ICU of Hospital Anchieta, Brasília, DF, Brazil, during 17 months. Patients were divided into two groups during the hospital stay: survivors group (SG) and nonsurvivors group (NSG). Patients proceeding from or transferred to another ICUs were excluded.
During the period of the study, 1,918 patients were admitted, 120 with septic shock (6.2%). For this sample, the mean age was 62 ± 20, SAPS3 was 71 ± 18, 55.8% were males, and the hospital mortality was 49% (n = 59). In the NSG group, there was a higher incidence of decreased level of consciousness (83.1% vs. 52.5%, P = 0.00), acute respiratory failure (96.6% vs. 83.6%, P = 0.03), hypocapnia (60.8% vs. 39.2%, P = 0.02), acidemia (77.4% vs. 50%, P = 0.01), need for invasive mechanical ventilation (83.1% vs. 45.9%, P = 0.00), and thrombocytopenia <60,000/mm3 (25.4% vs. 4.9%, P = 0.00). There was no difference between the groups regarding age (64 ± 21 vs. 61 ± 18, P = 0.37), PaO2/FiO2 ratio (174 ± 129 vs. 250 ± 236, P = 0.07), gender (47.5% vs. 63.9%, P = 0.37), incidence of acute renal injury (47.5% vs. 32.8%, P = 0.14), and arterial lactate (2.1 ± 1.1 vs. 1.8 ± 1.0, P = 0.13). The NSG group had greater SAPS3 score (82 ± 14 vs. 60 ± 15, P = 0.00). After logistic regression, only decreased level of consciousness (P = 0.00) and need for invasive mechanical ventilation (P = 0.01) were independently associated with hospital mortality.
In patients with septic shock, decreased level of consciousness and need for invasive mechanical ventilation were independently associated with hospital mortality.
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