Late recognition and illness severity are determinants of early death in severe septic patients

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dc.contributor.authorMachado, Flávia Ribeiro [UNIFESP]
dc.contributor.authorSalomão, Reinaldo [UNIFESP]
dc.contributor.authorRigato, Otelo
dc.contributor.authorFerreira, Elaine Maria
dc.contributor.authorSchettino, Guilherme
dc.contributor.authorMohovic, Tatiane
dc.contributor.authorSilva, Carla
dc.contributor.authorCastro, Isac
dc.contributor.authorSilva, Eliezer
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionLatin American Sepsis Institute
dc.contributor.institutionSírio Libanês Hospital Intensive Care Unit
dc.contributor.institutionHospital Israelita Albert Einstein Intensive Care Unit
dc.date.accessioned2015-06-14T13:45:24Z
dc.date.available2015-06-14T13:45:24Z
dc.date.issued2013-05-01
dc.description.abstractOBJECTIVE: To identify the independent variables associated with death within 4 days after the first sepsis-induced organ dysfunction. METHODS: In this prospective observational study, severe sepsis and septic shock patients were classified into 3 groups: Group 1, survivors; Group 2, late non-survivors; and Group 3, early non-survivors. Early death was defined as death occurring within 4 days after the first sepsis-induced organ dysfunction. Demographic, clinical and laboratory data were collected and submitted to univariate and multinomial analyses. RESULTS: The study included 414 patients: 218 (52.7%) in Group 1, 165 (39.8%) in Group 2, and 31 (7.5%) in Group 3. A multinomial logistic regression analysis showed that age, Acute Physiology and Chronic Health Evaluation II score, Sepsis-related Organ Failure Assessment score after the first 24 hours, nosocomial infection, hepatic dysfunction, and the time elapsed between the onset of organ dysfunction and the sepsis diagnosis were associated with early mortality. In contrast, Black race and a source of infection other than the urinary tract were associated with late death. Among the non-survivors, early death was associated with Acute Physiology and Chronic Health Evaluation II score, chronic renal failure, hepatic dysfunction Sepsis-related Organ Failure Assessment score after 24 hours, and the duration of organ dysfunction. CONCLUSION: Factors related to patients' intrinsic characteristics and disease severity as well as the promptness of sepsis recognition are associated with early death among severe septic patients.en
dc.description.affiliationFederal University of São Paulo Department of Anesthesiology Pain and Critical Care
dc.description.affiliationLatin American Sepsis Institute
dc.description.affiliationFederal University of São Paulo Department of Infectious Diseases
dc.description.affiliationSírio Libanês Hospital Intensive Care Unit
dc.description.affiliationHospital Israelita Albert Einstein Intensive Care Unit
dc.description.affiliationUnifespUNIFESP, Department of Anesthesiology Pain and Critical Care
dc.description.affiliationUnifespUNIFESP, Department of Infectious Diseases
dc.description.sourceSciELO
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)pt
dc.format.extent586-591
dc.identifierhttps://dx.doi.org/10.6061/clinics/2013(05)02
dc.identifier.citationClinics. Faculdade de Medicina / USP, v. 68, n. 5, p. 586-591, 2013.
dc.identifier.doi10.6061/clinics/2013(05)02
dc.identifier.fileS1807-59322013000500586.pdf
dc.identifier.issn1807-5932
dc.identifier.scieloS1807-59322013000500586
dc.identifier.urihttps://repositorio.unifesp.br/handle/11600/7739
dc.identifier.wosWOS:000320463300002
dc.language.isoeng
dc.publisherFaculdade de Medicina / USP
dc.relation.ispartofClinics
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectPrognosisen
dc.subjectMortalityen
dc.subjectSepsisen
dc.titleLate recognition and illness severity are determinants of early death in severe septic patientsen
dc.typeinfo:eu-repo/semantics/article
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