Daisuke Kudo1, Shigeki Kushimoto2, Noriko Miyagawa3, Tetsuya Sato4, Masatsugu Hasegawa5, Fumihito Ito6, Sathoshi Yamanouchi7, Hiroyuki Honda8, Kohkichi Andoh9, Hajime Furukawa10, Yasuo Yamada11, Yuta Tsujimoto12, Manabu Okuyama13. 1. Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; Department of Emergency and Critical Care Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. Electronic address: kudodaisuke@med.tohoku.ac.jp. 2. Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; Department of Emergency and Critical Care Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. Electronic address: kussie@emergency-medicine.med.tohoku.ac.jp. 3. Department of Emergency and Critical Care Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. Electronic address: m-noriko@hosp.tohoku.ac.jp. 4. Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan; Department of Emergency and Critical Care Medicine, Tohoku University Hospital, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. 5. Department of Emergency Center, Hachinohe City Hospital, 1 Bisyamontaira, Ojitamukaiaza, Hachinohe 031-8555, Japan. 6. Department of Emergency and Critical Care Medicine, Ohta General Hospital Foundation, Ohta Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama 963-8558, Japan. 7. Department of Emergency and Critical Care Medicine, Osaki Citizen Hospital, 3-8-1 Furukawahonami, Osaki 989-6183, Japan. 8. Department of Advanced Disaster Medicine and Emergency Critical Care Center, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-Dori, Chuo-ku, Niigata 951-8510, Japan. 9. Emergency and Critical Care Department, Sendai City Hospital, 1-1-1 Asutonagamachi, Taihaku-ku, Sendai 982-8502, Japan. 10. Department of Emergency Medicine, South Miyagi Medical Center, 38-1 Nishi, Ogawara, Shibata-gun 989-1253, Japan. 11. Department of Emergency Medicine, Sendai Medical Center, 2-8-8 Miyagino, Miyagino-ku, Sendai 983-8520, Japan. 12. Department of Emergency and Critical Care Medicine, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Oaza, Yamagata 990-2292, Japan. 13. Department of Critical Care Medicine, Akita University Hospital, 44-2 Hasunuma, Hiroomoteaza, Akita 010-8543, Japan. Electronic address: okuyamanabu@med.akita-u.ac.jp.
Abstract
PURPOSE: Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. MATERIAL AND METHODS: A prospective observational study was performed in 10 ICUs to obtain data from patients with severe sepsis. Multivariate analyses to examine in-hospital mortality were performed. RESULTS: Data of 573 patients were analyzed. In-hospital mortality rate was 19.4% (111/573). The incidences of DIC, ARDS, and AKI were 58.4%, 18.7%, and 41.7%, while the associated mortality rates were 28.9%, 36.4%, and 31.8%, respectively. In multiple regression model, DIC (odds ratio 2.71, 95% confidence interval [CI] 1.45-5.27) and AKI stage 3 (odds ratio 1.98, 95% CI 1.07-3.63) were significantly associated with higher in-hospital all-cause mortality. DIC (hazard ratio 2.58, 95% CI 1.53-4.55) and AKI stage 3 (hazard ratio 1.73, 95% CI 1.07-2.80) were also significantly associated with longer survival durations. However, severe ARDS was not associated with these outcomes. CONCLUSIONS: DIC and AKI are frequent complications in patients with severe sepsis. In this study, DIC, and AKI stage 3 were independent risk factors of in-hospital mortality.
PURPOSE: Disseminated intravascular coagulations (DIC), acute respiratory distress syndrome (ARDS), and acute kidney injury (AKI) are major organ dysfunctions that occur in patients with sepsis. This study aimed to elucidate the impact of these organ dysfunctions on mortality in patients with severe sepsis. MATERIAL AND METHODS: A prospective observational study was performed in 10 ICUs to obtain data from patients with severe sepsis. Multivariate analyses to examine in-hospital mortality were performed. RESULTS: Data of 573 patients were analyzed. In-hospital mortality rate was 19.4% (111/573). The incidences of DIC, ARDS, and AKI were 58.4%, 18.7%, and 41.7%, while the associated mortality rates were 28.9%, 36.4%, and 31.8%, respectively. In multiple regression model, DIC (odds ratio 2.71, 95% confidence interval [CI] 1.45-5.27) and AKI stage 3 (odds ratio 1.98, 95% CI 1.07-3.63) were significantly associated with higher in-hospital all-cause mortality. DIC (hazard ratio 2.58, 95% CI 1.53-4.55) and AKI stage 3 (hazard ratio 1.73, 95% CI 1.07-2.80) were also significantly associated with longer survival durations. However, severe ARDS was not associated with these outcomes. CONCLUSIONS: DIC and AKI are frequent complications in patients with severe sepsis. In this study, DIC, and AKI stage 3 were independent risk factors of in-hospital mortality.
Authors: Kaice A LaFavers; Chadi A Hage; Varun Gaur; Radmila Micanovic; Takashi Hato; Shehnaz Khan; Seth Winfree; Simit Doshi; Ranjani N Moorthi; Homer Twigg; Xue-Ru Wu; Pierre C Dagher; Edward F Srour; Tarek M El-Achkar Journal: Am J Physiol Renal Physiol Date: 2022-06-27
Authors: Julie Ng; Fei Guo; Anna E Marneth; Sailaja Ghanta; Min-Young Kwon; Joshua Keegan; Xiaoli Liu; Kyle T Wright; Baransel Kamaz; Laura A Cahill; Ann Mullally; Mark A Perrella; James A Lederer Journal: Blood Adv Date: 2020-10-13