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. 2011 Apr;27(2):180-4.
doi: 10.4103/0970-9185.81816.

The impact of acute organ dysfunction on patients' mortality with severe sepsis

Takeshi Umegaki  1 , Hiroshi Ikai, Yuichi Imanaka
Affiliations

The impact of acute organ dysfunction on patients' mortality with severe sepsis

Takeshi Umegaki et al. J Anaesthesiol Clin Pharmacol. 2011 Apr.

Abstract

Background: Severe sepsis leads to organ failure and results in high mortality. Organ dysfunction is an independent prognostic factor for intensive care unit (ICU) mortality. The objective of the present study was to determine the effect of acute organ dysfunction for ICU mortality in patients with severe sepsis using administrative data.

Materials and methods: A multicenter cross-sectional study was performed in 2008. The study was conducted in 112 teaching hospitals in Japan. All cases with severe sepsis in ICU were identified from administrative data.

Results: Administrative data acquired for 4196 severe septic cases of 75,069 cases entered in the ICU were used to assess patient outcomes. Cardiovascular dysfunction was identified as the most major organ dysfunction (73.0%), and the followings were respiratory dysfunction (69.4%) and renal dysfunction (39.0%), respectively. The ICU mortality and 28-day means 28-day from ICU entry. were 18.8% and 27.7%, respectively. After adjustment for age, gender, and severity of illness, the hazard ratio of 2, 3, and ≥4, the organ dysfunctions for one organ failure on ICU mortality was 1.6, 2.0, and 2.7, respectively.

Conclusions: We showed that the number of organ dysfunction was a useful indicator for ICU mortality on administrative data. The hepatic dysfunction was the highest mortality among organ dysfunctions. The hazard ratio of ICU death in severe septic patients with multiple organ dysfunctions was average 2.2 times higher than severe septic patients with single organ dysfunction.

Keywords: Intensive care units; mortality; multicenter study; multiple organ failure; sepsis.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Kaplan– Meier curve of each number of organ dysfunctions: Mortality is calculated from the entry into the ICU. 1; single organ dysfunction, 2; two organ dysfunctions, 3; three organ dysfunctions, ≥4; over four organ dysfunctions
See this image and copyright information in PMC

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