Introduction
Methods
Study design, data source, and definitions
Statistical analysis
Ethical approval
Results
Prevalence, characteristics, and in-hospital mortality of sepsis patients defined by eSOFA or Sepsis-3 criteria
Characteristic | eSOFA (−) n = 1143 | eSOFA (+) n = 573 | Sepsis-3 (−) n = 781 | Sepsis-3 (+) n = 935 |
---|---|---|---|---|
Median age (IQR) | 79 (62–84) | 82 (75–87)** | 78 (57–84) | 81 (74–86)‡ |
Gender, n (%) | ||||
Male | 642 (56.2) | 346 (60.4) | 414 (53.0) | 574 (61.4)‡ |
BMI, kg/m2, median (IQR) | 23 (20–26) | 23 (20–26) | 24 (21–26) | 23 (20–26)† |
Bedridden, n (%) | 580 (50.7) | 310 (54.1)** | 388 (49.7) | 502 (53.7)‡ |
Type of hospital admission, n (%) | ||||
Medical | 1047 (91.6) | 506 (88.3)* | 691 (88.5) | 862 (92.2)‡ |
Elective surgery | 85 (7.4) | 43 (7.5) | 75 (9.6) | 53 (5.7)‡ |
Emergency surgery | 11 (1.0) | 24 (4.2)** | 15 (1.9) | 20 (2.1) |
McCabe and Jackson classification, n (%) | ||||
Nonfatal | 814 (71.2) | 394 (68.8) | 524 (67.1) | 684 (73.2)‡ |
Ultimately fatal | 169 (14.8) | 120 (20.9)** | 112 (14.3) | 177 (18.9)† |
Rapidly fatal | 21 (1.8) | 24 (4.2)** | 22 (2.8) | 23 (2.5) |
Charlson Comorbidity Index, median (IQR) | 1 (1–3) | 2 (1–3)** | 1 (0–3) | 2 (1–3)‡ |
Comorbidities (Charlson), n (%) | ||||
Cancera | 174 (15.2) | 131 (22.9)** | 133 (17.0) | 172 (18.4) |
Congestive heart failure | 12 (1.0) | 28 (4.9)** | 9 (1.2) | 31 (3.3)‡ |
Chronic pulmonary disease | 237 (20.7) | 148 (25.8)* | 150 (19.2) | 235 (25.1)‡ |
Diabetes | 328 (28.7) | 126 (22.0)** | 206 (26.4) | 248 (26.5) |
Liver disease | 15 (1.3) | 17 (3.0)* | 13 (1.7) | 19 (2.0) |
Renal disease | 46 (4.0) | 31 (5.4) | 10 (1.3) | 67 (7.2)‡ |
Chronic organ dysfunction (APACHE II), n (%) | ||||
Cardiovascular | 11 (1.0) | 26 (4.5)** | 8 (1.0) | 29 (3.1)‡ |
Respiratory | 37 (3.2) | 70 (12.2)** | 42 (5.4) | 65 (7.0) |
Liver | 15 (1.3) | 17 (3.0)* | 13 (1.7) | 19 (2.0) |
Renal | 34 (3.0) | 21 (3.7) | 10 (1.3) | 45 (4.8)‡ |
Immunosuppression | 94 (8.2) | 57 (9.9) | 62 (7.9) | 89 (9.5) |
Site of infection, n (%) | ||||
Pneumonia | 660 (57.7) | 374 (65.3)** | 432 (55.3) | 602 (64.4)‡ |
Urogenital tract infection | 90 (7.9) | 11 (1.9)** | 68 (8.7) | 33 (3.5)‡ |
Intra-abdominal infection | 105 (9.2) | 72 (12.6)* | 81 (10.4) | 96 (10.3) |
Skin/soft tissue infection | 25 (2.2) | 3 (0.5)* | 24 (3.1) | 4 (0.4)‡ |
Septicemia/bacteremia | 18 (1.6) | 13 (2.3) | 18 (2.3) | 13 (1.4) |
Two or more infections | 61 (5.3) | 66 (11.5)** | 55 (7.0) | 72 (7.7) |
Outcomes | ||||
Median hospital LOS (IQR) | 17 (9–30) | 23 (11–40)* | 17 (9–29) | 20 (11–38)† |
Required ICU admission, n (%) | 33 (2.9) | 218 (38.1)** | 16 (2.0) | 235 (25.1)‡ |
Death, n (%) | 86 (7.5) | 267 (46.6)** | 54 (6.9) | 299 (32.0)‡ |
Prevalence, characteristics, and in-hospital mortality of Sepsis-3+/eSOFA−, Sepsis-3−/eSOFA+, and Sepsis-3+/eSOFA+ patients
Characteristic | Sepsis-3 (−) eSOFA (−) n = 683 | Sepsis-3 (+) eSOFA (−) n = 460 | Sepsis-3 (−) eSOFA (+) n = 98 | Sepsis-3 (+) eSOFA (+) n = 475 |
---|---|---|---|---|
Median age (IQR) | 77 (56–84) | 81 (73–85)** | 81 (73–86)**‡ | 82 (75–87)** |
Gender, n (%) | ||||
Male | 359 (52.6) | 283 (61.5)** | 43 (43.9) | 291 (61.3)** |
BMI, kg/m2, median (IQR) | 24 (21–26) | 23 (20–26)* | 24 (20–25) | 23 (20–26)* |
Bedridden, n (%) | 336 (49.2) | 242 (52.6)** | 52 (53.1) | 260 (54.7)** |
Type of hospital admission, n (%) | ||||
Medical | 610 (89.3) | 437 (95.0)**‡ | 81 (82.7) | 425 (89.5) |
Elective surgery | 66 (9.7) | 19 (4.1)**† | 9 (9.2) | 34 (7.2) |
Emergency surgery | 7 (1.0) | 4 (0.9)‡ | 8 (8.2)**† | 16 (3.4)** |
McCabe and Jackson classification, n (%) | ||||
Nonfatal | 464 (67.9) | 350 (76.1)**† | 60 (61.2) | 334 (70.3) |
Ultimately fatal | 90 (13.2) | 79 (17.2) | 22 (22.4)* | 98 (20.6)** |
Rapidly fatal | 14 (2.0) | 7 (1.5) | 8 (8.2)**† | 16 (3.4) |
Charlson Comorbidity Index, median (IQR) | 1 (0–3) | 2 (1–3)**‡ | 2 (1–3)** | 2 (1–3)** |
Comorbidities (Charlson), n (%) | ||||
Cancera | 103 (15.1) | 71 (15.4)† | 30 (30.6)**† | 101 (21.3)** |
Congestive heart failure | 5 (0.7) | 7 (1.5)‡ | 4 (4.1)** | 24 (5.1)** |
Chronic pulmonary disease | 121 (17.7) | 116 (25.2)** | 29 (29.6)** | 119 (25.1)** |
Diabetes | 181 (26.5) | 147 (32.0)*‡ | 25 (25.5) | 101 (21.3)* |
Liver disease | 9 (1.3) | 6 (1.3) | 4 (4.1)* | 13 (2.7) |
Renal disease | 7 (1.0) | 39 (8.5)** | 3 (3.1) | 28 (5.9)** |
Chronic organ dysfunction (APACHE II), n (%) | ||||
Cardiovascular | 4 (0.6) | 7 (1.5)‡ | 4 (4.1)** | 22 (4.6)** |
Respiratory | 16 (2.3) | 21 (4.6)*‡ | 26 (26.5)**‡ | 44 (9.3)** |
Liver | 9 (1.3) | 6 (1.3) | 4 (4.1)* | 13 (2.7) |
Renal | 6 (0.9) | 28 (6.1)** | 4 (4.1)** | 17 (3.6)** |
Immunosuppression | 56 (8.2) | 38 (8.3) | 6 (6.1) | 51 (10.7) |
Site of infection, n (%) | ||||
Pneumonia | 369 (54.0) | 291 (63.3)** | 63 (64.3) | 311 (65.5)** |
Urogenital tract infection | 65 (9.5) | 25 (5.4)*‡ | 3 (3.1)* | 8 (1.7)** |
Intra-abdominal infection | 72 (10.5) | 33 (7.2)‡ | 9 (9.2) | 63 (13.3) |
Skin/soft tissue infection | 22 (3.2) | 3 (0.7)** | 2 (2.0)† | 1 (0.2)** |
Septicemia/bacteremia | 15 (2.2) | 3 (0.7)* | 3 (3.1) | 10 (2.1) |
Two or more infections | 41 (6.0) | 20 (4.3)‡ | 14 (14.3)** | 52 (10.9)** |
Outcomes | ||||
Median hospital LOS (IQR) | 17 (9–28) | 17 (10–33)‡ | 23 (11–38)* | 23 (11–41)** |
Required ICU admission, n (%) | 7 (1.0) | 26 (5.7)**‡ | 9 (9.2)**‡ | 207 (43.6)** |
Death, n (%) | 38 (5.6) | 48 (10.4)**‡ | 16 (16.3)**‡ | 251 (52.8)** |