Juha Rannikko1, Jaana Syrjänen2, Tapio Seiskari3, Janne Aittoniemi3, Reetta Huttunen2. 1. Department of Internal Medicine, Tampere University Hospital, Box 2000, FI-33521 Tampere, Finland. Electronic address: juha.rannikko@gmail.com. 2. Department of Internal Medicine, Tampere University Hospital, Box 2000, FI-33521 Tampere, Finland. 3. Department of Clinical Microbiology, Fimlab Laboratories, Tampere, Finland.
Abstract
OBJECTIVE: Few studies have sought to establish how often death after sepsis is related to the sepsis and how often underlying diseases have a major role in case fatality. METHODS: In this retrospective cohort study, data were collected on 497 cases with blood culture-positive sepsis in an emergency department (ED). RESULTS: Sepsis was categorized as severe in 31% of cases; 7% had septic shock. The quick Sepsis-related Organ Failure Assessment score was positive in 136 out of 473 cases (29%). Ninety-eight patients died by day 90; in 16 of these cases (16%) the death was sepsis-related in a patient without a rapidly fatal underlying disease, in 45 cases (46%) the death was sepsis-related in a patient with a rapidly fatal underlying disease, and in 37 cases (38%) the death was unrelated to sepsis. Sepsis-related death occurred in 58 out of 61 cases (95%) by day 28. CONCLUSIONS: Underlying diseases were found to have a considerable role in the death of patients suffering from blood culture-positive sepsis in an ED of a developed country, as only 16% of the deaths by day 90 occurred where death was sepsis-related and the patient had a life-expectancy of more than 6 months. Improving the outcome of sepsis with new treatments is thus challenging. It is possible that day 7+day 28 mortality is a more appropriate endpoint than day 90 mortality when studying the outcome of sepsis, as this time-span includes most of the patients whose death was related to sepsis.
OBJECTIVE: Few studies have sought to establish how often death after sepsis is related to the sepsis and how often underlying diseases have a major role in case fatality. METHODS: In this retrospective cohort study, data were collected on 497 cases with blood culture-positive sepsis in an emergency department (ED). RESULTS:Sepsis was categorized as severe in 31% of cases; 7% had septic shock. The quick Sepsis-related Organ Failure Assessment score was positive in 136 out of 473 cases (29%). Ninety-eight patients died by day 90; in 16 of these cases (16%) the death was sepsis-related in a patient without a rapidly fatal underlying disease, in 45 cases (46%) the death was sepsis-related in a patient with a rapidly fatal underlying disease, and in 37 cases (38%) the death was unrelated to sepsis. Sepsis-related death occurred in 58 out of 61 cases (95%) by day 28. CONCLUSIONS: Underlying diseases were found to have a considerable role in the death of patients suffering from blood culture-positive sepsis in an ED of a developed country, as only 16% of the deaths by day 90 occurred where death was sepsis-related and the patient had a life-expectancy of more than 6 months. Improving the outcome of sepsis with new treatments is thus challenging. It is possible that day 7+day 28 mortality is a more appropriate endpoint than day 90 mortality when studying the outcome of sepsis, as this time-span includes most of the patients whose death was related to sepsis.
Authors: S A Maskarinec; L P Park; F Ruffin; N A Turner; N Patel; E M Eichenberger; D van Duin; T Lodise; V G Fowler; J T Thaden Journal: Clin Microbiol Infect Date: 2020-02-28 Impact factor: 8.067
Authors: Felipe Pérez-García; Maria Ángeles Jiménez-Sousa; Susana Soria; Pablo Jorge-Monjas; Amanda Fernández-Rodríguez; Esther Gómez-Sánchez; María Heredia-Rodríguez; Estefanía Gómez-Pesquera; Pedro Martínez-Paz; Eduardo Tamayo; Salvador Resino Journal: Front Med (Lausanne) Date: 2020-05-14
Authors: Katryn Paquette; David Sweet; Robert Stenstrom; Sarah N Stabler; Alexander Lawandi; Murtaza Akhter; Adam C Davidson; Marko Gavric; Rehman Jinah; Zahid Saeed; Koray Demir; Sassan Sangsari; Kelly Huang; Amirali Mahpour; Chris Shamatutu; Chelsea Caya; Jean-Marc Troquet; Greg Clark; Titus Wong; Cedric P Yansouni; Matthew P Cheng Journal: Open Forum Infect Dis Date: 2021-06-17 Impact factor: 3.835