Clinical outcomes and prognostic factors of patients with sepsis caused by intra-abdominal infection in the intensive care unit: a post-hoc analysis of a prospective cohort study in Korea
Chan Hee Park, Jeong Woo Lee, Hak‐Jae Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Suk‐Kyung Hong, the Korean Sepsis Alliance (KSA) investigators, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung‐Eun Ko, Young‐Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Chae-Man Lim, Suk‐Kyung Hong, Sang Hyun Kwak, Song-I. Lee, Jae Young Moon, Kyung Chan Kim, Sunghoon Park, Tai Sun Park, Youjin Chang, Gil Myeong Seong, Heung Bum Lee, Jeongwon Heo, Jae Myeong Lee, Woo Hyun Cho, Kyeongman Jeon, Yeon Joo Lee, Sang‐Min Lee, Su Hwan Lee, Jong-Joon Ahn, Eun Young Choi
Abstract
BACKGROUND: Sepsis is the most common cause of death in hospitals, and intra-abdominal infection (IAI) accounts for a large portion of the causes of sepsis. We investigated the clinical outcomes and factors influencing mortality of patients with sepsis due to IAI. METHODS: This post-hoc analysis of a prospective cohort study included 2126 patients with sepsis who visited 16 tertiary care hospitals in Korea (September 2019-February 2020). The analysis included 219 patients aged > 19 years who were admitted to intensive care units owing to sepsis caused by IAI. RESULTS: The incidence of septic shock was 47% and was significantly higher in the non-survivor group (58.7% vs 42.3%, p = 0.028). The overall 28-day mortality was 28.8%. In multivariable logistic regression, after adjusting for age, sex, Charlson Comorbidity Index, and lactic acid, only coagulation dysfunction (odds ratio: 2.78 [1.47-5.23], p = 0.001) was independently associated, and after adjusting for each risk factor, only simplified acute physiology score III (SAPS 3) (p < 0.001) and continuous renal replacement therapy (CRRT) (p < 0.001) were independently associated with higher 28-day mortality. CONCLUSIONS: The SAPS 3 score and acute kidney injury with CRRT were independently associated with increased 28-day mortality. Additional support may be needed in patients with coagulopathy than in those with other organ dysfunctions due to IAI because patients with coagulopathy had worse prognosis.