Clinical Features, Short-Term Mortality, and Prognostic Risk Factors of Septic Patients Admitted to Internal Medicine Units: Results of an Italian Multicenter Prospective Study
- PMID: 26825876
- PMCID: PMC5291546
- DOI: 10.1097/MD.0000000000002124
Clinical Features, Short-Term Mortality, and Prognostic Risk Factors of Septic Patients Admitted to Internal Medicine Units: Results of an Italian Multicenter Prospective Study
Abstract
Only a few studies provided data on the clinical history of sepsis within internal Medicine units. The aim of the study was to assess the short-term mortality and to evaluate the prognostic risk factors in a large cohort of septic patients treated in internal medicine units. Thirty-one internal medicine units participated to the study. Within each participating unit, all admitted patients were screened for the presence of sepsis. A total of 533 patients were included; 78 patients (14.6%, 95%CI 11.9, 18.0%) died during hospitalization; mortality rate was 5.5% (95% CI 3.1, 9.6%) in patients with nonsevere sepsis and 20.1% (95%CI 16.2, 28.8%) in patients with severe sepsis or septic shock. Severe sepsis or septic shock (OR 4.41, 95%CI 1.93, 10.05), immune system weakening (OR 2.10, 95%CI 1.12, 3.94), active solid cancer (OR 2.14, 95% CI 1.16, 3.94), and age (OR 1.03 per year, 95% CI 1.01, 1.06) were significantly associated with an increased mortality risk, whereas blood culture positive for Escherichia coli was significantly associated with a reduced mortality risk (OR 0.46, 95%CI 0.24, 0.88). In-hospital mortality of septic patients treated in internal medicine units appeared similar to the mortality rate obtained in recent studies conducted in the ICU setting.
Conflict of interest statement
The authors have no conflicts of interest to disclose.
Figures
Similar articles
-
Incidence, risk factors, and outcome of severe sepsis and septic shock in adults. A multicenter prospective study in intensive care units. French ICU Group for Severe Sepsis.JAMA. 1995 Sep 27;274(12):968-74. JAMA. 1995. PMID: 7674528
-
Time- and fluid-sensitive resuscitation for hemodynamic support of children in septic shock: barriers to the implementation of the American College of Critical Care Medicine/Pediatric Advanced Life Support Guidelines in a pediatric intensive care unit in a developing world.Pediatr Emerg Care. 2008 Dec;24(12):810-5. doi: 10.1097/PEC.0b013e31818e9f3a. Pediatr Emerg Care. 2008. PMID: 19050666
-
Epidemiology and outcome of severe sepsis and septic shock in intensive care units in mainland China.PLoS One. 2014 Sep 16;9(9):e107181. doi: 10.1371/journal.pone.0107181. eCollection 2014. PLoS One. 2014. PMID: 25226033 Free PMC article.
-
Increased body mass index and adjusted mortality in ICU patients with sepsis or septic shock: a systematic review and meta-analysis.Crit Care. 2016 Jun 15;20(1):181. doi: 10.1186/s13054-016-1360-z. Crit Care. 2016. PMID: 27306751 Free PMC article.
-
Outcome of patients with sepsis and septic shock after ICU treatment.Langenbecks Arch Surg. 1998 Mar;383(1):44-8. doi: 10.1007/s004230050090. Langenbecks Arch Surg. 1998. PMID: 9627170 Review.
Cited by
-
Identifying patients with acute bacterial skin and skin structure infection who need blood cultures.Intern Emerg Med. 2019 Mar;14(2):203-206. doi: 10.1007/s11739-018-02017-9. Epub 2019 Jan 1. Intern Emerg Med. 2019. PMID: 30600527 No abstract available.
-
Frequency and mortality of septic shock in Europe and North America: a systematic review and meta-analysis.Crit Care. 2019 May 31;23(1):196. doi: 10.1186/s13054-019-2478-6. Crit Care. 2019. PMID: 31151462 Free PMC article.
-
Mid-Regional Pro-Adrenomedullin Can Predict Organ Failure and Prognosis in Sepsis?Int J Mol Sci. 2023 Dec 13;24(24):17429. doi: 10.3390/ijms242417429. Int J Mol Sci. 2023. PMID: 38139258 Free PMC article.
-
Impact of the implementation of a Sepsis Code Program in medical patient management: a cohort study in an Internal Medicine ward.Rev Esp Quimioter. 2022 Apr;35(2):178-191. doi: 10.37201/req/132.2021. Epub 2022 Jan 31. Rev Esp Quimioter. 2022. PMID: 35099161 Free PMC article.
-
Sepsis in Internal Medicine: blood culture-based subtypes, hospital outcomes, and predictive biomarkers.Front Med (Lausanne). 2025 Jan 30;12:1503868. doi: 10.3389/fmed.2025.1503868. eCollection 2025. Front Med (Lausanne). 2025. PMID: 39950122 Free PMC article.
References
-
- Angus DC, van der Poll T. Severe sepsis and septic shock. N Engl J Med 2013; 369:840–851. - PubMed
-
- Angus DC, Linde-Zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med 2001; 29:1303–1310. - PubMed
-
- Sundararajan V, Macisaac CM, Presneill JJ, et al. Epidemiology of sepsis in Victoria, Australia. Crit Care Med 2005; 33:71–80. - PubMed
-
- Martin GS, Mannino DM, Eaton S, et al. The epidemiology of sepsis in the United States from 1979 through 2000. N Engl J Med 2003; 348:1546–1554. - PubMed
-
- Vincent JL, Rello J, Marshall J, et al. EPIC II Group of Investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA 2009; 302:2323–2329. - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical