Risk factors for death in septic shock A retrospective cohort study comparing trauma and non-trauma patients - Inserm - Institut national de la santé et de la recherche médicale Accéder directement au contenu
Article Dans Une Revue Medicine Année : 2017

Risk factors for death in septic shock A retrospective cohort study comparing trauma and non-trauma patients

Résumé

The aim of this study was to compare septic shock directly associated-mortality between severe trauma patients and nontrauma patients to assess the role of comorbidities and age. We conducted a retrospective study in an intensive care unit (ICU) (15 beds) of a university hospital (928 beds). From January 2009 to May 2015, we reviewed 2 anonymized databases including severe trauma patients and nontrauma patients. We selected the patients with a septic shock episode. Among 385 patients (318 nontrauma patients and 67 severe trauma patients), the ICU death rate was 43%. Septic shock was directly responsible for death among 35% of our cohort, representing 123 (39%) nontrauma patients and 10 (15%) trauma patients (P<0.0). A sequential organ failure assessment score above 12 (odds ratio [OR]: 6.8; 95% confident interval (CI) [1.3-37], P=0.025) was independently associated with septic shock associated-mortality, whereas severe trauma was a protective factor (OR: 0.26; 95% CI [0.08-0.78], P=0.01). From these independent risk factors, we determined the probability of septic shock associated-mortality. The receiver-operating characteristics curve has an area under the curve at 0.76 with sensitivity of 55% and specificity of 86%. Trauma appears as a protective factor, whereas the severity of organ failure has a major role in the mortality of septic shock. However, because of the study's design, unmeasured confounding factors should be taken into account in our findings.
Fichier principal
Vignette du fichier
MEDAM medi-96-e9241.pdf (319.71 Ko) Télécharger le fichier
Origine : Publication financée par une institution
Loading...

Dates et versions

hal-01729781 , version 1 (24-04-2018)

Identifiants

Citer

Sophie Medam, Laurent Zieleskiewicz, Gary Duclos, Karine Baumstarck, Anderson Loundou, et al.. Risk factors for death in septic shock A retrospective cohort study comparing trauma and non-trauma patients. Medicine, 2017, 96 (50), pp.e9241. ⟨10.1097/MD.0000000000009241⟩. ⟨hal-01729781⟩
86 Consultations
89 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More