Sepsis-related mortality in 497 cases with blood culture-positive sepsis in an emergency department

• Main Authors: Juha Rannikko, Jaana Syrjänen, Tapio Seiskari, Janne Aittoniemi, Reetta Huttunen
• Format: Article
• Language: English
• Published: Elsevier 2017-05-01
• Series: International Journal of Infectious Diseases
• Subjects: Attributable mortality; Blood culture; Infectious disease; Related mortality; Sepsis; Survival; qSOFA
• Online Access: http://www.sciencedirect.com/science/article/pii/S1201971217300887
• ISSN: 1201-9712; 1878-3511

Objective: Few studies have sought to establish how often death after sepsis is related to the sepsis and how often underlying diseases have a major role in case fatality. Methods: In this retrospective cohort study, data were collected on 497 cases with blood culture-positive sepsis in an emergency department (ED). Results: Sepsis was categorized as severe in 31% of cases; 7% had septic shock. The quick Sepsis-related Organ Failure Assessment score was positive in 136 out of 473 cases (29%). Ninety-eight patients died by day 90; in 16 of these cases (16%) the death was sepsis-related in a patient without a rapidly fatal underlying disease, in 45 cases (46%) the death was sepsis-related in a patient with a rapidly fatal underlying disease, and in 37 cases (38%) the death was unrelated to sepsis. Sepsis-related death occurred in 58 out of 61 cases (95%) by day 28. Conclusions: Underlying diseases were found to have a considerable role in the death of patients suffering from blood culture-positive sepsis in an ED of a developed country, as only 16% of the deaths by day 90 occurred where death was sepsis-related and the patient had a life-expectancy of more than 6 months. Improving the outcome of sepsis with new treatments is thus challenging. It is possible that day 7 + day 28 mortality is a more appropriate endpoint than day 90 mortality when studying the outcome of sepsis, as this time-span includes most of the patients whose death was related to sepsis.