Predictors of 30-day mortality in medical patients with severe sepsis or septic shock

Objectives. To evaluate independent predictors of 30-day mortality in patients with severe sepsis or septic shock. Background. Severe sepsis and septic shock are associated with increased mortality. Admission APACHE II score is the gold standard for assessing prognosis in critically ill, but several other predictors of mortality have been evaluated. Methods. We retrospectively evaluated clinical and laboratory data in adult patients with severe sepsis or septic shock as predictors of 30-day mortality. 

Results. Thirty-day mortality was 62.7%. Nonsurvivors in comparison to survivors were significantly more likely to be trea-ted with noradrenalin, renal replacement therapy, mechanically ventilated, to have suffered a fungal infection, had lower admission arterial pH, increased admission Acute Physiology, Age, Chronic Health Evaluation (APACHE) II score and a higher peak lactate level (5.6 ± 6.2 vs 3.1 ± 1.75, p=0.021). Binary logistic regression demonstrated that only peak in-hospital serum lactate level was a significant independent predictor of 30-day mortality (OR 1.367, 95% CI 1.041 to 1.795, p=0.025). 

Conclusion. Only peak in-hospital lactate significantly and independently predicts 30-day mortality in severe sepsis or septic shock medical patients.

severe sepsis, septic shock, 30-day mortality, serum lac-tate

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