Late recognition and illness severity are determinants of early death in severe septic patients
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | https://repositorio.unifesp.br/handle/11600/7739 https://dx.doi.org/10.6061/clinics/2013(05)02 |
Resumo: | OBJECTIVE: 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. |
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Machado, Flávia Ribeiro [UNIFESP]Salomão, Reinaldo [UNIFESP]Rigato, OteloFerreira, Elaine MariaSchettino, GuilhermeMohovic, TatianeSilva, CarlaCastro, IsacSilva, EliezerUniversidade Federal de São Paulo (UNIFESP)Latin American Sepsis InstituteSírio Libanês Hospital Intensive Care UnitHospital Israelita Albert Einstein Intensive Care Unit2015-06-14T13:45:24Z2015-06-14T13:45:24Z2013-05-01Clinics. Faculdade de Medicina / USP, v. 68, n. 5, p. 586-591, 2013.1807-5932https://repositorio.unifesp.br/handle/11600/7739https://dx.doi.org/10.6061/clinics/2013(05)02S1807-59322013000500586.pdfS1807-5932201300050058610.6061/clinics/2013(05)02WOS:000320463300002OBJECTIVE: 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.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Federal University of São Paulo Department of Anesthesiology Pain and Critical CareLatin American Sepsis InstituteFederal University of São Paulo Department of Infectious DiseasesSírio Libanês Hospital Intensive Care UnitHospital Israelita Albert Einstein Intensive Care UnitUNIFESP, Department of Anesthesiology Pain and Critical CareUNIFESP, Department of Infectious DiseasesSciELO586-591engFaculdade de Medicina / USPClinicsPrognosisMortalitySepsisLate recognition and illness severity are determinants of early death in severe septic patientsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALS1807-59322013000500586.pdfapplication/pdf282783${dspace.ui.url}/bitstream/11600/7739/1/S1807-59322013000500586.pdfb7e442320a5e818e862a8bf1d7dc82d6MD51open accessTEXTS1807-59322013000500586.pdf.txtS1807-59322013000500586.pdf.txtExtracted texttext/plain35479${dspace.ui.url}/bitstream/11600/7739/2/S1807-59322013000500586.pdf.txt70c5aaff0fdee7a16db3452313bc0e47MD52open access11600/77392022-12-07 15:39:17.203open accessoai:repositorio.unifesp.br:11600/7739Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-05-25T12:22:36.711988Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Late recognition and illness severity are determinants of early death in severe septic patients |
title |
Late recognition and illness severity are determinants of early death in severe septic patients |
spellingShingle |
Late recognition and illness severity are determinants of early death in severe septic patients Machado, Flávia Ribeiro [UNIFESP] Prognosis Mortality Sepsis |
title_short |
Late recognition and illness severity are determinants of early death in severe septic patients |
title_full |
Late recognition and illness severity are determinants of early death in severe septic patients |
title_fullStr |
Late recognition and illness severity are determinants of early death in severe septic patients |
title_full_unstemmed |
Late recognition and illness severity are determinants of early death in severe septic patients |
title_sort |
Late recognition and illness severity are determinants of early death in severe septic patients |
author |
Machado, Flávia Ribeiro [UNIFESP] |
author_facet |
Machado, Flávia Ribeiro [UNIFESP] Salomão, Reinaldo [UNIFESP] Rigato, Otelo Ferreira, Elaine Maria Schettino, Guilherme Mohovic, Tatiane Silva, Carla Castro, Isac Silva, Eliezer |
author_role |
author |
author2 |
Salomão, Reinaldo [UNIFESP] Rigato, Otelo Ferreira, Elaine Maria Schettino, Guilherme Mohovic, Tatiane Silva, Carla Castro, Isac Silva, Eliezer |
author2_role |
author author author author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Latin American Sepsis Institute Sírio Libanês Hospital Intensive Care Unit Hospital Israelita Albert Einstein Intensive Care Unit |
dc.contributor.author.fl_str_mv |
Machado, Flávia Ribeiro [UNIFESP] Salomão, Reinaldo [UNIFESP] Rigato, Otelo Ferreira, Elaine Maria Schettino, Guilherme Mohovic, Tatiane Silva, Carla Castro, Isac Silva, Eliezer |
dc.subject.eng.fl_str_mv |
Prognosis Mortality Sepsis |
topic |
Prognosis Mortality Sepsis |
description |
OBJECTIVE: 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. |
publishDate |
2013 |
dc.date.issued.fl_str_mv |
2013-05-01 |
dc.date.accessioned.fl_str_mv |
2015-06-14T13:45:24Z |
dc.date.available.fl_str_mv |
2015-06-14T13:45:24Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
Clinics. Faculdade de Medicina / USP, v. 68, n. 5, p. 586-591, 2013. |
dc.identifier.uri.fl_str_mv |
https://repositorio.unifesp.br/handle/11600/7739 https://dx.doi.org/10.6061/clinics/2013(05)02 |
dc.identifier.issn.none.fl_str_mv |
1807-5932 |
dc.identifier.file.none.fl_str_mv |
S1807-59322013000500586.pdf |
dc.identifier.scielo.none.fl_str_mv |
S1807-59322013000500586 |
dc.identifier.doi.none.fl_str_mv |
10.6061/clinics/2013(05)02 |
dc.identifier.wos.none.fl_str_mv |
WOS:000320463300002 |
identifier_str_mv |
Clinics. Faculdade de Medicina / USP, v. 68, n. 5, p. 586-591, 2013. 1807-5932 S1807-59322013000500586.pdf S1807-59322013000500586 10.6061/clinics/2013(05)02 WOS:000320463300002 |
url |
https://repositorio.unifesp.br/handle/11600/7739 https://dx.doi.org/10.6061/clinics/2013(05)02 |
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586-591 |
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Faculdade de Medicina / USP |
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Faculdade de Medicina / USP |
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