Open AccessPredictors of Mortality in Septic Shock: Findings for 57 Patients Diagnosed on Admission to Emergency or within 24 hours of Admission to Intensive Care
Author(s) -
Yücel N,
Togal T,
Gedik E,
Ertan C,
Kayabas U,
Akgün FS,
Bayindir Y
Publication year - 2012
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490791201900602
Subject(s) - medicine , septic shock , intensive care unit , emergency department , sofa score , intensive care , retrospective cohort study , sepsis , intensive care medicine , psychiatry
Objective To identify the risk factors that influence outcome for patients who are diagnosed with septic shock in the emergency department at presentation or within 24 hours after admission to intensive care unit. Methods A retrospective study of 57 adult patients with septic shock was conducted between March 1, 2006 and August 31, 2009. Results The patients were 23 males and 34 females with a median age of 67 years (20 to 92 years). Thirty‐three (58%) of 57 patients died in hospital and 24 (42%) survived. Multivariate analysis identified low blood pH (OR <0.001; 95% CI <0.001‐0.53) and low bicarbonate level (OR 0.81; 95% CI 0.70‐0.95) at emergency department or intensive care unit admission as useful predictors of 3‐day in‐hospital mortality. Low blood pH (OR <0.001; 95% CI <0.001‐0.05), low bicarbonate level (OR 0.75; 95% CIs 0.61‐0.91), long duration of symptoms (OR 1.49; 95% CI 1.04‐2.13), high MEDS score (OR 1.56; 95% CIs 1.06‐2.30), and high SOFA score (OR 1.57; 95% CI 1.12‐2.20) were risk factors for 14‐day in‐hospital mortality. Renal failure (OR 7.58; 95% CI 1.28‐44.77), lower pulmonary tract infection (OR 3.58; 95% CI 1.10‐11.58), high MEDS score (OR 1.42; 95% CI 1.05‐1.93) and high APACHE II score (OR 1.34; 95% CI 1.13‐1.60) were risk factors for 28‐day in‐hospital mortality. Conclusions Several factors signaling poor short‐term outcome for this patient group are low blood pH, low serum bicarbonate level, longer duration of symptoms, lower respiratory tract infection and renal failure. MEDS and SOFA scores might be helpful in the ED to stratify patients with septic shock according to mortality risk.