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. 2022 May 2:15:4585-4593.
doi: 10.2147/IJGM.S357978. eCollection 2022.

Sepsis in a Combined Medical and Surgical High Dependency/Intensive Care Unit in Singapore: A Cohort Study and Survival Analysis

Xiao Jiang  1 , Faheem Ahmed Khan  1 , Min Qi Ow  2 , Hermione Mei Niang Poh  2
Affiliations

Sepsis in a Combined Medical and Surgical High Dependency/Intensive Care Unit in Singapore: A Cohort Study and Survival Analysis

Xiao Jiang et al. Int J Gen Med. .

Abstract

Background: Sepsis is a common indication for intensive care unit (ICU) admission and is associated with significant mortality and morbidity. The aim of our study was to first assess the incidence, severity, short-term and long-term mortality of sepsis in a combined medical and surgical high dependency/ ICU in Singapore, and to identify factors associated with increasing short-term and long-term mortality.

Methods: All admissions from July 1 to December 31, 2017 were retrospectively screened and clinical data were collected. Patients were followed up until 3 years post ICU admission.

Results: Of a total 1526 admissions, 281 had infection at ICU admission, and 254 (16.6%) fulfilled sepsis-3 criteria for sepsis. A total of 141 (9.2%) had septic shock. The 30-day, 1-year, 2-year and 3-year mortality of sepsis patients were 19.3%, 25.2%, 30.3% and 32.3%, respectively. Lung was the most common site of infection. Compared with 30-day sepsis survivors, non-survivors were older (median age 70 vs 63, P <0.001), had higher percentage of lung infection (65.3% vs 36.1%, P <0.05), higher admission Sequential Organ Failure Assessment (SOFA) score (median 9 vs 5, P <0.001), and longer ICU stay (median days: 4 vs 3, P = 0.037). In stepwise Cox regression analysis, lung infection was an independent risk factor for both increasing 30-day and 3-year mortality. Immunocompromised host, increasing age and SOFA score were associated with higher 30-day mortality. Diabetes, admission quick Sequential Organ Failure Assessment (qSOFA) score >1 and unplanned ICU re-admission were associated with increasing 3-year mortality in 30-day survivors.

Conclusion: Our retrospective cohort single center study first reported sepsis admission incidence of 16.6% in a combined medical and surgical high dependency/ICU in Singapore, with significant short-term and long-term mortality. Lung infection was an independent risk factor for both 30-day and 3-year mortality.

Keywords: incidence; intensive care unit; mortality; sepsis; septic shock; severity.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study algorithm.
Figure 2
Figure 2
3-year survival plot comparing septic shock and sepsis without shock group.
See this image and copyright information in PMC

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