Sepsis in the Emergency Room: Which are the Poor Prognostic Factors?

Abstract

Abstract Background. Understanding the underlying cause of mortality in sepsis has broad implications for both trials design and clinical care. A one-size-fits-it-all treatment without considering underlying comorbidities and particularities of a specific patient may have a huge impact on prognosis. Materials and methods. We performed a retrospective, single center observational study of patients admitted in Emergency Department taking into account the suspicion of an infection, serious enough to produce a systemic inflammatory response syndrome. Of this population, we selected the septic patient (Sepsis-3 definition) and studied the impact of comorbidities on prognosis. Results. 125 patients were included. We found that institutionalized patient and respiratory insufficiency were the factors with the biggest impact on prognosis. Close to that, the age was a factor to be taken into account when discussing about prognosis. Other factors as malignancy, diabetes mellitus, cardiac and renal failure were not associated with ominous prognosis, although may have an impact. Two scores (MEDS and NEWS2) and a biomarker were also found to be useful when making a prognosis in such patients. Conclusions. In this retrospective cohort, the institutionalized patient and patients with with respiratory have poor prognosis, while in other diseases, MEDS, NEWS2 and presepsin were reliable prognostic factors.