• Journal of critical care · Jun 2019

    Admission characteristics predictive of in-hospital death from hospital-acquired sepsis: A comparison to community-acquired sepsis.

    • Teresa Padro, Carmen Smotherman, Shiva Gautam, Cynthia Gerdik, Kelly Gray-Eurom, and Faheem W Guirgis.
    • University of Florida College of Medicine-Jacksonville, Department of Emergency Medicine, Jacksonville, FL, United States of America.
    • J Crit Care. 2019 Jun 1; 51: 145-148.

    PurposeHealthcare associated (HA) sepsis is associated with increased resource utilization and mortality compared with community acquired (CA) sepsis. The purpose of this study was to identify independent predictors of in-hospital mortality from HA-sepsis.Materials And MethodsRetrospective study of adult patients admitted with HA or CA-sepsis. Predictors were identified using logistic regression.ResultsThere were 3917 sepsis encounters, of which 3186 were CA and 731 were HA. History of stroke (83/731, 11%) and myocardial infarction (70/731, 10%) were higher in HA than CA-sepsis (stroke: 258/3186, 8%, p = .005; myocardial infarction: 213/3186, 7%, p = .007). HA-sepsis patients required more mechanical ventilation (153/731, 21%) than CA-patients (218/3186, 7%, p < .001) and had a higher rate of vasopressor use (334/731, 46%) than CA patients (832/3186, 26%, p < .001). The HA group had longer ICU lengths of stay (LOS) than CA patients did at 9 days and 2.8 days, respectively (p < .0001). Moderate to severe liver disease (OR = 27, 95%CI 1.4, 513, p = .031) and congestive heart failure (CHF, 5.81, 95% CI 1.3, 26, p = .025) were predictive of in-hospital mortality from HA-sepsis.ConclusionsLiver disease and CHF were independent predictors of in-hospital mortality in HA-sepsis. HA-sepsis patients had increased prevalence of previous stroke, myocardial infarction, and liver disease.Copyright © 2019. Published by Elsevier Inc.

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