Document Detail


Analysis of organ failure and mortality in sepsis due to secondary peritonitis.
MedLine Citation:
PMID:  23044280     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES: To identify the organs most susceptible to develop multiorgan dysfunction syndrome (MODS) in patients with sepsis due to secondary peritonitis, and to determine the outcome and mortality predicting utility of the SOFA (Sequential Organ Failure Assessment) system. DESIGN: A prospective, observational cohort study was made. SETTING: The resuscitation unit of a third-level university hospital. PATIENTS: A prospective, observational cohort study was made of 102 patients with sepsis of abdominal origin and failure of at least one organ related to the infection. The demographic characteristics were documented, along with the abdominal origin of sepsis, mortality after 28 days, and the daily SOFA score. RESULTS: The mortality rate after 28 days was 55%. A total of 53% of the patients presented failure of two or more organs on the first day of admission. The mean daily SOFA score was significantly higher among the patients that died after day 4 of admission. The variables showing a statistically significant correlation to increased mortality were: MODS (P=.000), central nervous system failure (P=.000) and SOFA score on day 4 of admission (P=.012). The area under the ROC curve showed the mortality predicting capacity of the SOFA score on day 4 of admission to be 0.703 (95%CI 0.538-0.853; P=.026). The maximum discriminating capacity was recorded for MODS, with an area under the ROC curve of 0.776 (95%CI 0.678-0.874; P=.000). CONCLUSIONS: Organ failure outcome as predicted by the SOFA score showed high precision - the mean SOFA score on day 4 of admission being a good mortality predictor. MODS was the main cause of death, while central nervous system, renal and respiratory failure were identified as the mortality risk factors.
Authors:
J Hernández-Palazón; D Fuentes-García; S Burguillos-López; P Domenech-Asensi; T V Sansano-Sánchez; F Acosta-Villegas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-5
Journal Detail:
Title:  Medicina intensiva / Sociedad Espanola de Medicina Intensiva y Unidades Coronarias     Volume:  -     ISSN:  1578-6749     ISO Abbreviation:  Med Intensiva     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9207689     Medline TA:  Med Intensiva     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier España, S.L. y SEMICYUC. All rights reserved.
Affiliation:
Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Arrixaca, Murcia, España. Electronic address: joapal@ono.com.
Vernacular Title:
Análisis de la insuficiencia de órganos y mortalidad en la sepsis por peritonitis secundaria.
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