Urosepsis 30-day mortality, morbidity, and their risk factors: SERPENS study, a prospective, observational multi-center study

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dc.authoridtandogdu, zafer/0000-0002-5309-3656
dc.contributor.authorTandogdu, Zafer
dc.contributor.authorKoves, Bela
dc.contributor.authorRistovski, Slobodan
dc.contributor.authorBalci, Mustafa Bahadir Can
dc.contributor.authorRennesund, Kristin
dc.contributor.authorGravas, Stavros
dc.contributor.authorNale, Djordje
dc.date.accessioned2024-06-12T11:14:08Z
dc.date.available2024-06-12T11:14:08Z
dc.date.issued2024
dc.departmentTrakya Üniversitesien_US
dc.description.abstractPurpose To provide a descriptive report of mortality and morbidity in the first 30 days of diagnosis of urosepsis. Secondary aim is to identify risk factors of unfavourable outcomes.Methods Prospective observational multicentre cohort study conducted from September 2014 to November 2018 in European hospitals. Adult patients (>= 18 years) diagnosed with acute urosepsis according to Sepsis-2 criteria with confirmed microbiological infection were included. Outcomes were classified in one of four health states: death, multiple organ failure, single organ failure, and recovery at day 30 from onset of urosepsis. Descriptive statistics and ordinal logistic regression analysis was performed.Results Three hundred and fifty four patients were recruited, and 30-day mortality rate was 2.8%, rising to 4.6% for severe sepsis. All patients who died had a SOFA score of >= 2 at diagnosis. Upon initial diagnosis, 79% (n = 281) of patients presented with OF. Within 30 days, an additional 5% developed OF, resulting in a total of 84% affected. Charlson score (OR 1.14 CI 1.01-1.28), patients with respiratory failure at baseline (OR 2.35, CI 1.32-4.21), ICU admission within the past 12 months (OR 2.05, CI 1.00-4.19), obstruction causative of urosepsis (OR 1.76, CI 1.02-3.05), urosepsis with multi-drug-resistant(MDR) pathogens (OR 2.01, CI 1.15-3.53), and SOFA baseline score >= 2 (OR 2.74, CI 1.49-5.07) are significantly associated with day 30 outcomes (OF and death).Conclusions Impact of comorbidities and MDR pathogens on outcomes highlights the existence of a distinct group of patients who are prone to mortality and morbidity. These findings underscore the need for the development of pragmatic classifications to better assess the severity of UTIs and guide management strategies. Study registration: Clinicaltrials.gov registration number NCT02380170.Conclusions Impact of comorbidities and MDR pathogens on outcomes highlights the existence of a distinct group of patients who are prone to mortality and morbidity. These findings underscore the need for the development of pragmatic classifications to better assess the severity of UTIs and guide management strategies. Study registration: Clinicaltrials.gov registration number NCT02380170.en_US
dc.description.sponsorshipEuropean Association of Urology Research Foundation (EAU-RF); Cubist Ltden_US
dc.description.sponsorshipThis research was supported by the European Association of Urology Research Foundation (EAU-RF). The EAU-RF received an unconditional grant from Cubist Ltd in 2015 for research in urosepsis. The EAU-RF or Cubist had no role in the study design, data collection, analysis and interpretation; or preparation of the report.en_US
dc.identifier.doi10.1007/s00345-024-04979-2
dc.identifier.issn0724-4983
dc.identifier.issn1433-8726
dc.identifier.issue1en_US
dc.identifier.pmid38730089en_US
dc.identifier.scopus2-s2.0-85192879920en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1007/s00345-024-04979-2
dc.identifier.urihttps://hdl.handle.net/20.500.14551/23798
dc.identifier.volume42en_US
dc.identifier.wosWOS:001218454800002en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.relation.ispartofWorld Journal Of Urologyen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectSevere UTIen_US
dc.subjectUrosepsisen_US
dc.subjectAntibiotic Resistanceen_US
dc.subjectSepsisen_US
dc.subjectDefinitionsen_US
dc.titleUrosepsis 30-day mortality, morbidity, and their risk factors: SERPENS study, a prospective, observational multi-center studyen_US
dc.typeArticleen_US

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