What are the independent parameters associated with increased mortality risk in patients with severe sepsis or septic shock in the intensive care unit?

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dc.contributor.authorYildiz, Ozlem
dc.contributor.authorTabakoglu, Erhan
dc.date.accessioned2024-06-12T10:05:12Z
dc.date.available2024-06-12T10:05:12Z
dc.date.issued2022
dc.departmentTrakya Üniversitesien_US
dc.description.abstractObjective: Determining the factors associated with prognosis in patients with sepsis admitted to the intensive care unit who were treated according to international guidelines. Patients were evaluated with respect to treatment results, morbidity and mortality rates, infection foci and pathogens. Materials and Methods: A total of 43 patients with severe sepsis who were treated in Trakya University Medical Faculty, Department of Medical Intensive Care, between July 2009 and December 2009, were enrolled in thisprospective observational study. Patients were grouped as survivors and non-survivors. Clinical characteristics and APACHE II, SAPS II, SOFA scores were recorded. Factors associated with mortality were analyzed by Cox regression. Results: Overall mortality rate was 23.2%. Patients with failure in three or more organs had higher mortality (p = 0.001). Also, mortality rates were higher in patients with cardiovascular, renal, hematological and neurological failure in the first day (p = 0.002, p = 0.011, p = 0.020, p = 0.019, respectively). All scores at the 24th and 72nd hours were significantly higher in the non-survivor group compared to survivors (p <0.05, for all). While the initial SOFA and APACHE II values were higher in non-survivors compared to survivors (p = 0.013 and p = 0.017, respectively), initial SAPS II scores were similar (p = 0.107). The diagnosis of septic shock (HR: 0.080, 95%CI: 0.007-0.961), chronic heart failure (HR: 0.133, 95%CI: 0.032-0.558), inappropriate empirical antibiotic use (HR: 0.106, 95%CI: 0.034- 0.326), the number of organs failing on the first day of admission (HR: 17.091, 95%CI: 2.877-101.529), cardiovascular failure (HR: 0.427, 95%CI: 0.201-0.906) and renal insufficiency (HR: 0.075, 95%CI: 0.016-0.348) were found to be associated with mortality. Conclusion: The presence of chronic heart failure, inappropriately administered empirical antibiotherapy, renal and cardiac failure on the first day of admission were the notable independent factors that increased the mortality risk of patients with severe sepsis and septic shock. In addition, SOFA, APACHE II, and SAPS II scores were higher in sepsis patients who ultimately died. Initiating correct antibiotherapy in the early period and applying appropriate measures against organ failure may increase survival in cases with severe sepsis.en_US
dc.identifier.doi10.34087/cbusbed.1010810
dc.identifier.endpage119en_US
dc.identifier.issn2147-9607
dc.identifier.issue1en_US
dc.identifier.startpage112en_US
dc.identifier.trdizinid532878en_US]
dc.identifier.urihttps://doi.org/10.34087/cbusbed.1010810
dc.identifier.urihttps://search.trdizin.gov.tr/yayin/detay/532878
dc.identifier.urihttps://hdl.handle.net/20.500.14551/13302
dc.identifier.volume9en_US
dc.indekslendigikaynakTR-Dizinen_US
dc.language.isoenen_US
dc.relation.ispartofCelal Bayar Üniversitesi Sağlık Bilimleri Enstitüsü Dergisien_US
dc.relation.publicationcategoryMakale - Ulusal Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.titleWhat are the independent parameters associated with increased mortality risk in patients with severe sepsis or septic shock in the intensive care unit?en_US
dc.typeArticleen_US

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