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Prognostic factors for late death in septic shock survivors: a multi-center, prospective, registry-based observational study

Authors
 Sang-Min Kim  ;  Seung Mok Ryoo  ;  Tae Gun Shin  ;  Yoo Seok Park  ;  You Hwan Jo  ;  Tae Ho Lim  ;  Sung Phil Chung  ;  Sung-Hyuk Choi  ;  Gil Joon Suh  ;  Won Young Kim 
Citation
 INTERNAL AND EMERGENCY MEDICINE, Vol.17(3) : 865-871, 2022-04 
Journal Title
INTERNAL AND EMERGENCY MEDICINE
ISSN
 1828-0447 
Issue Date
2022-04
MeSH
Adult ; Humans ; Lactic Acid ; Prognosis ; Prospective Studies ; Registries ; Sepsis* ; Shock, Septic* ; Survivors
Keywords
Chronic medical disease ; Long-term mortality ; Post-acute period ; Sepsis ; Septic shock
Abstract
Septic shock patients who survive past the acute period are associated with an increased risk of long-term mortality. However, factors for predicting late death remain unclear. We aimed to investigate the prognostic factors associated with late mortality in septic shock patients with 28-day survival after admission. This retrospective observational study used a prospective, multi-center registry of septic shock patients between October 2015 and December 2019 involving 12 emergency departments (EDs) from the Korean Shock Society. Adult septic shock patients visiting the ED with 28-day survival after admission were included. Among 4624 septic shock patients, 3588 (77.6%) who survived past day 28 were analyzed. The 90-day mortality rate was 14.2%. Non-survivors were older (66.8 vs. 68.9 years; p = 0.032) and had higher lactate levels (3.7 vs. 4.0 mmol/L; p = 0.028) than survivors. Pulmonary and hepatobiliary infections and a history of malignancy (27.7 vs. 57.5%; p < 0.001) were more frequent in the non-survivor group than in the survivor group. Independent risk factors for late death on multivariate regression analysis were age; malignancy; and hemoglobin, blood urea nitrogen, and albumin levels. The length of intensive care unit stay and Sequential Organ Failure Assessment score were independently associated with late death. Approximately, one-seventh of septic shock patients who survived past day 28 of admission died by day 90. Physicians must pay attention to survivors with these risk factors during the post-acute period as they have an increased mortality risk.
Full Text
https://link.springer.com/article/10.1007/s11739-021-02847-0
DOI
10.1007/s11739-021-02847-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Park, Yoo Seok(박유석) ORCID logo https://orcid.org/0000-0003-1543-4664
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191353
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