Origin of Sepsis Associated with the Short-Term Mortality of Patients: A Retrospective Study Using the eICU Collaborative Research Database

脓毒症病因与患者短期死亡率的关系:一项基于eICU协作研究数据库的回顾性研究

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Abstract

OBJECTIVE: The aim of this study was to compare the clinical characteristics and short-term mortality of patients with abdominal and pulmonary sepsis. DESIGN: Retrospective cohort study. SETTING: Adult intensive care units (ICUs) at tertiary hospitals. PARTICIPANTS: Adult ICU patients from 2014 to 2015 in the eICU Collaborative Research Database. INTERVENTIONS: In univariate analysis, we compared the differences in the characteristics of patients in each group. Logistic regression models were used to evaluate the relationships between primary site of sepsis and short-term prognosis. PRIMARY AND SECONDARY OUTCOME MEASURES: Hospital and ICU survival. RESULTS: The final dataset included 7023 pulmonary and 2360 abdominal sepsis patients, who accounted for 74.84% and 25.16%, respectively. We compared the results of the baseline characteristics, vital signs and laboratory indicators between the two groups. In the logistic regression models, we found that the hospital and ICU mortality of patients with abdominal sepsis was higher than that with pulmonary sepsis (p < 0.05, OR = 1.15, p < 0.05, OR = 1.19, respectively), although these results were no longer significantly after adjustment for confounders, but in the subgroups with SOFA score ≧ 8, the adjusted hospital mortality rate of patients with abdominal sepsis was 1.30 times higher than that of patients with pulmonary sepsis (p < 0.005, OR = 1.30, 95% CI 1.09-1.55), while there was no significant difference in the subgroups that SOFA score < 8. CONCLUSION: In the patients with SOFA score ≧ 8, the adjusted hospital mortality of patients with abdominal sepsis was higher than patients with pulmonary sepsis.

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