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. 2023 Jul 13;11(1):e48.
doi: 10.22037/aaem.v11i1.2029. eCollection 2023.

Pre-hospital Prognostic Factors of 30-Day Survival in Sepsis Patients; a Retrospective Cohort Study

Thongpitak Huabbangyang  1 , Rossakorn Klaiangthong  1 , Fahsai Jaibergban  1 , Chanathip Wanphen  2 , Thanakorn Faikhao  2 , Passakorn Banjongkit  2 , Ratchaporn Kuchapan  2
Affiliations

Pre-hospital Prognostic Factors of 30-Day Survival in Sepsis Patients; a Retrospective Cohort Study

Thongpitak Huabbangyang et al. Arch Acad Emerg Med. .

Abstract

Introduction: According to excising findings, if the emergency management system (EMS) operation will be developed, the survival outcome of sepsis patients might improve. This study aimed to evaluate the pre-hospital associated factors of survival in sepsis patients.

Methods: This retrospective cohort study was conducted on patients diagnosed with sepsis, coded with the Thailand emergency medical triage protocol and criteria-based dispatch symptom group 17. Information on the 30-day survival rate of patients was obtained from the electronic medical records. Pre-hospital factors associated with 30-day survival were analyzed using univariate and multivariate logistic regression analyses and were reported using odds ratio (OR) with 95% confidence interval (CI).

Results: 300 patients diagnosed with sepsis were enrolled. Among them, 232 (77.3%) survived within 30 days. Non-survived cases had significantly older age (p = 0.019), lower oxygen saturations (92.5% vs. 95.0%; p = 0.003), higher heart rate (p = 0.001), higher respiratory rate (p < 0.001), lower level of consciousness (p < 0.001), higher disease severity based on qSOFA score (p = 0.001), and higher need for invasive airway management (p = 0.001) and supplementary oxygen (p = 0.001). The survival rate improved by 3.5% with every 1% increase in pre-hospital oxygen saturation (adjusted OR = 1.035, 95% CI: 1.005-1.066, p = 0.020) and the survival probabilities of patients who responded to voice (adjusted OR = 0.170, 95% CI: 0.050-0.579, p = 0.005), those who responded to pain (adjusted OR = 0.130, 95% CI: 0.036-0.475, p = 0.002), and those who were unresponsive (adjusted OR = 0.086, 95% CI: 0.026-0.278, p-value < 0.001) were lower than patients who were alert.

Conclusion: The 30-day survival rate of patients with sepsis managed by the EMS team was 77.3%. Pre-hospital oxygen saturation and level of consciousness were associated with the survival of patients with sepsis who were managed in the pre-hospital setting.

Keywords: Emergency medical services; emergency treatment; sepsis; survival.

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Conflict of interest statement

The authors have no conflicting interests to declare.

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