Reasons for death in patients with sepsis and septic shock

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Ari Moskowitz
  • ,
  • Yasser Omar
  • ,
  • Maureen Chase
  • ,
  • Sharukh Lokhandwala
  • ,
  • Parth Patel
  • ,
  • Lars Wiuff Andersen
  • Michael N Cocchi
  • ,
  • Michael W Donnino

Purpose Understanding the underlying cause of mortality in sepsis has broad implications for both clinical care and interventional trial design. However, reasons for death in sepsis remain poorly understood. We sought to characterize reasons for in-hospital mortality in a population of patients with sepsis or septic shock. Materials and methods We performed a retrospective review of patients admitted to the intensive care unit with sepsis or septic shock who died during their index admission. Reasons for death were classified into 6 categories determined a priori by group consensus. Interrater reliability was calculated and Fleiss κ reported. The associations between selected patient characteristics (eg, serum lactate) and reason for death were also assessed. Results One hundred fifteen patients were included. Refractory shock (40%) and comorbid withdrawal of care (44%) were the most common reasons for death. Overall interrater agreement was substantial (κ = 0.61, P < .01). Lactate was higher in patients who died because of refractory shock as compared with those who died for other reasons (4.7 vs 2.8 mmol/L, P < .01). Conclusion In this retrospective cohort, refractory shock and comorbid withdrawal of care were the most common reasons for death. Following prospective validation, the classification methodology presented here may be useful in the design/interpretation of trials in sepsis.

OriginalsprogEngelsk
TidsskriftJournal of Critical Care
Vol/bind38
Sider (fra-til)284-288
Antal sider5
ISSN0883-9441
DOI
StatusUdgivet - apr. 2017

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