Factors Affecting Prognosis in Sepsis Patients Admitted to Intensive Care Unit

Abstract

In this study we aimed to examine relation between patients with prediagnosis of sepsis during ICU admission and comorbities; their vital signs, age, gender, GGT (Gamma Glutamyl Transferase), uric acid, creatinine, PLT (thrombocyte), RDW (Red Cell Distribution Width), MPV (Mean Platelet Volume), CRP (C-reactive protein) and lactate levels and whether or not these have prognostic value for mortality in sepsis.
We examined files of patients who were admitted to ICU with sepsis prediagnosis retrospectively. One hundred and fifty patients with sepsis prediagnosis were admitted to ICU between January 2014 and December 2015. Upon admission GCS (Glasgow Coma Scale), APACHE II (Acute Physiological and Chronic Health Evaluation), systolic- diastolic blood pressure (SBP-DBP) and pulse rates, uric acid, GGT, blood glucose, CRP, urea, potassium (K), sodium (Na), total cholesterol, triglyceride, WBC, lymphocyte (%), neutrophile (%), MPV, RDW, thrombocyte, arterial blood gases (ABG: Ph, PCO2, PO2, lactate, HCO3, BE) values were recorded. Also co-morbidity diseases inotropic usage were asked and recorded. Mortality rate for 150 patients in this study was 84.7%. DBP (p=0.046), thrombocyte (p=0.008) and total cholesterol(p=0.019) levels were significantly lower and APACHE II scores (p=0.008) and creatinine (p=0.001) levels were significantly higher in deceased patients than discharged patients. There was no significant difference between groups regarding co-morbid diseases. Mortality rate was higher in patients who needed positive inotropic support during ICU admission, as expected (p=0.002)
Sepsis is a complicated, highly fatal syndrome and needs multidisciplinary approach. We concluded that APACHE II, low PLT count, low DBP, need for inotropic support, low total cholesterol levels and high creatinine levels upon ICU admission in sepsis patients can help determining prognosis. Whereas uric acid levels, RDW, MPV, WBC are not helpful.