Journal article
Not all organ dysfunctions are created equal – Prevalence and mortality in sepsis
Journal of critical care, v 48, pp 257-262
Dec 2018
PMID: 30245367
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
While organ dysfunctions within sepsis have been widely studied, interaction between measures of organ dysfunction remains an understudied area. The objective of this study is to quantify the impact of organ dysfunction on in-hospital mortality in infected population.
Descriptive and multivariate analyses of retrospective data including patients (age ≥ 18 years) hospitalized at the study hospital from July 2013 to April 2016 who met the criteria for an infection visit (62,057 unique visits).
The multivariate logistic regression model had an area under the curve of 0.9. Highest odds ratio (OR) associated with increased mortality risk was identified as fraction of inspired oxygen (FiO2) > 21% (OR = 5.8 and 95% Confidence Interval (CI) 1.8–35.6), and elevated lactate >2.0 mmol/L (OR = 2.45 (95% CI = 2.1–2.8)). Most commonly observed measures of organ dysfunction within mortality visits included elevated lactate (> 2.0 mmol/L), mechanical ventilation, and oxygen saturation (SpO2)/FiO2 ratio (< 421) at least once within 48 h prior to or 24 h after anti-infective administration.
There exist differences in measures of organ dysfunction occurrence and their association with mortality. These findings support increased clinical efforts to identify sepsis patients to inform diagnostic decisions.
•Understanding how many and which organ systems fail impact outcomes in sepsis.•We quantified and visualized organ system dysfunction in sepsis and mortality.•There are intra- and inter-system differences in acute organ system dysfunction.•Changes in renal, metabolic and respiratory systems are essential for surveillance.
Metrics
Details
- Title
- Not all organ dysfunctions are created equal – Prevalence and mortality in sepsis
- Creators
- Muge Capan - Decision Sciences & MIS Department, LeBow College of Business, Drexel University, Gerri C. LeBow Hall, 3220 Market Street, Philadelphia, PA 19104, USA.Stephen Hoover - Christiana Care Health SystemJulie S. Ivy - North Carolina State UniversityKristen E. Miller - MedStar HealthRyan Arnold - Hahnemann University HospitalS.E.P.S.I.S (Sepsis Early Prediction Support Implementation System) Collaborative
- Publication Details
- Journal of critical care, v 48, pp 257-262
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Decision Sciences (and Management Information Systems)
- Web of Science ID
- WOS:000449360800042
- Scopus ID
- 2-s2.0-85053518941
- Other Identifier
- 991019167818404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine