Abstract
According to previous studies, the clinical course of sepsis could be affected by preexisting medical conditions, which are very common among patients with sepsis. This observational study aimed at investigating whether common chronic medical conditions affect the 90-day mortality risk in adult Caucasian patients with sepsis. A total of 482 patients with sepsis were enrolled in this study. The ninety-day mortality was the primary outcome; organ failure was the secondary outcome. Sepsis-related organ failure assessment (SOFA) scores and the requirements for organ support were evaluated to assess organ failure. A multivariate Cox regression model for the association between the 90-day mortality risk and chronic preexisting medical conditions adjusted for all relevant confounders and mortality predictors revealed the highest hazard ratio for patients with chronic kidney disease (CKD) (hazard ratio, 2.25; 95% CI, 1.46-3.46; p = 0.0002). Patients with CKD had higher SOFA scores than patients without CKD (8.9 ± 4.0 and 6.5 ± 3.4, respectively; p < 0.0001). Additionally, an analysis of organ-specific SOFA scores revealed higher scores in three organ systems (kidney, cardiovascular and coagulation). Patients with CKD have the highest 90-day mortality risk compared with patients without CKD or with other chronic medical conditions.
Highlights
Conditions were retrospective in nature[12,13]
A multivariate Cox regression model for the association between the 90-day mortality risk and chronic preexisting medical conditions adjusted for all of the relevant confounders and mortality predictors revealed the highest hazard ratio for patients with Chronic kidney disease (CKD) (Table 2) followed by those with diabetes mellitus (NIDDM: hazard ratio, 1.65; 95% CI, 0.96-2.83; p = 0 .0684 and IDDM: hazard ratio, 1.62; 95% CI, 0.99-2.64; p = 0 .0527) and a history of cancer (Table 2)
According to our main findings, patients with CKD had the highest 90-day mortality risk compared with patients without CKD or patients with other chronic medical conditions
Summary
Conditions were retrospective in nature[12,13]. the major outcome of previous investigations was short-term mortality (28-day, ICU and hospital mortality)[12,13,14,15]. As several improved treatments for sepsis, especially for sepsis-associated organ dysfunction, have been developed in recent years[18], reevaluating the effect of common chronic medical conditions on the clinical course of patients with sepsis is important. This prospective observational study aimed at investigating whether and to what extent common chronic medical conditions (arterial hypertension, coronary heart disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease (CKD), insulin-dependent diabetes mellitus (IDDM), non-insulin-dependent diabetes mellitus (NIDDM), chronic liver disease, and history of stroke) affect the 90-day mortality risk in Caucasian patients with sepsis
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