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2015 ; 5
(ä): 10539
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Chronic kidney disease is associated with a higher 90-day mortality than other
chronic medical conditions in patients with sepsis
#MMPMID25995131
Mansur A
; Mulwande E
; Steinau M
; Bergmann I
; Popov AF
; Ghadimi M
; Beissbarth T
; Bauer M
; Hinz J
Sci Rep
2015[May]; 5
(ä): 10539
PMID25995131
show ga
According to previous studies, the clinical course of sepsis could be affected by
preexisting medical conditions, which are very common among patients with sepsis.
This observational study aimed at investigating whether common chronic medical
conditions affect the 90-day mortality risk in adult Caucasian patients with
sepsis. A total of 482 patients with sepsis were enrolled in this study. The
ninety-day mortality was the primary outcome; organ failure was the secondary
outcome. Sepsis-related organ failure assessment (SOFA) scores and the
requirements for organ support were evaluated to assess organ failure. A
multivariate Cox regression model for the association between the 90-day
mortality risk and chronic preexisting medical conditions adjusted for all
relevant confounders and mortality predictors revealed the highest hazard ratio
for patients with chronic kidney disease (CKD) (hazard ratio, 2.25; 95% CI,
1.46-3.46; p = 0.0002). Patients with CKD had higher SOFA scores than patients
without CKD (8.9 ± 4.0 and 6.5 ± 3.4, respectively; p < 0.0001). Additionally, an
analysis of organ-specific SOFA scores revealed higher scores in three organ
systems (kidney, cardiovascular and coagulation). Patients with CKD have the
highest 90-day mortality risk compared with patients without CKD or with other
chronic medical conditions.