Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients
(1) Background: Patients with sepsis following surgical intervention may exhibit fundamental distinctions from those experiencing sepsis without prior surgery. Despite the potential clinical importance of distinguishing these two sepsis subpopulations, dissimilarities, particularly in outcome, betwe...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-08-01
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| Series: | Biomedicines |
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| Online Access: | https://www.mdpi.com/2227-9059/11/8/2233 |
| _version_ | 1797585407966183424 |
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| author | Caspar Mewes Julius Runzheimer Carolin Böhnke Benedikt Büttner Marcus Nemeth José Hinz Michael Quintel Ashham Mansur |
| author_facet | Caspar Mewes Julius Runzheimer Carolin Böhnke Benedikt Büttner Marcus Nemeth José Hinz Michael Quintel Ashham Mansur |
| author_sort | Caspar Mewes |
| collection | DOAJ |
| description | (1) Background: Patients with sepsis following surgical intervention may exhibit fundamental distinctions from those experiencing sepsis without prior surgery. Despite the potential clinical importance of distinguishing these two sepsis subpopulations, dissimilarities, particularly in outcome, between surgical and non-surgical patients have been subject to limited scientific investigations in the existing literature. This study aimed to investigate the differences in mortality and sepsis-associated organ dysfunction between these two groups. (2) Methods: A retrospective analysis was conducted using data from a large cohort of prospectively enrolled patients with sepsis (n = 737) admitted to three intensive care units at University Medical Center Goettingen; patients were categorized into surgical (n = 582) and non-surgical sepsis groups (n = 155). The primary outcomes assessed were 28- and 90-day mortality rates, and secondary endpoints were multiple clinical parameters and measures of sepsis-associated organ dysfunction. (3) Results: Non-surgical patients presented a significantly higher 90-day mortality (37%) compared to surgical sepsis patients (30%, <i>p</i> = 0.0457). Moreover, the non-surgical sepsis group exhibited increased sepsis-associated organ dysfunction, as evidenced by higher average SOFA scores (<i>p</i> < 0.001), elevated levels of serum Procalcitonin (<i>p</i> = 0.0102), and a higher utilization of organ replacement therapies such as ventilation (p < 0.001), vasopressor treatment (<i>p</i> < 0.001), and renal replacement therapy (<i>p</i> = 0.0364). Additionally, non-surgical sepsis patients had higher organ-specific SOFA respiratory (<i>p</i> < 0.001), cardiovascular (<i>p</i> < 0.001), renal (<i>p</i> < 0.001), coagulation (0.0335), and central nervous system (<i>p</i> = 0.0206) subscores. (4) Conclusions: These results suggested that patients with non-surgical sepsis may face distinct challenges and a higher risk of adverse outcomes compared to patients with sepsis following surgical intervention. These findings have important implications for clinical decision-making, patient management, and resource allocation in sepsis care. |
| first_indexed | 2024-03-11T00:06:47Z |
| format | Article |
| id | doaj.art-adda6cc68c094a9b9ae32a4a5af0895e |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T00:06:47Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-adda6cc68c094a9b9ae32a4a5af0895e2023-11-19T00:21:15ZengMDPI AGBiomedicines2227-90592023-08-01118223310.3390/biomedicines11082233Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis PatientsCaspar Mewes0Julius Runzheimer1Carolin Böhnke2Benedikt Büttner3Marcus Nemeth4José Hinz5Michael Quintel6Ashham Mansur7Department of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, GermanyDepartment of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, GermanyDepartment of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, GermanyDepartment of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, GermanyDepartment of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, GermanyDepartment of Anesthesiology and Intensive Care Medicine, Klinikum Region Hannover, 30459 Hannover, GermanyDepartment of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, GermanyDepartment of Anesthesiology, University Medical Center Goettingen, 37075 Goettingen, Germany(1) Background: Patients with sepsis following surgical intervention may exhibit fundamental distinctions from those experiencing sepsis without prior surgery. Despite the potential clinical importance of distinguishing these two sepsis subpopulations, dissimilarities, particularly in outcome, between surgical and non-surgical patients have been subject to limited scientific investigations in the existing literature. This study aimed to investigate the differences in mortality and sepsis-associated organ dysfunction between these two groups. (2) Methods: A retrospective analysis was conducted using data from a large cohort of prospectively enrolled patients with sepsis (n = 737) admitted to three intensive care units at University Medical Center Goettingen; patients were categorized into surgical (n = 582) and non-surgical sepsis groups (n = 155). The primary outcomes assessed were 28- and 90-day mortality rates, and secondary endpoints were multiple clinical parameters and measures of sepsis-associated organ dysfunction. (3) Results: Non-surgical patients presented a significantly higher 90-day mortality (37%) compared to surgical sepsis patients (30%, <i>p</i> = 0.0457). Moreover, the non-surgical sepsis group exhibited increased sepsis-associated organ dysfunction, as evidenced by higher average SOFA scores (<i>p</i> < 0.001), elevated levels of serum Procalcitonin (<i>p</i> = 0.0102), and a higher utilization of organ replacement therapies such as ventilation (p < 0.001), vasopressor treatment (<i>p</i> < 0.001), and renal replacement therapy (<i>p</i> = 0.0364). Additionally, non-surgical sepsis patients had higher organ-specific SOFA respiratory (<i>p</i> < 0.001), cardiovascular (<i>p</i> < 0.001), renal (<i>p</i> < 0.001), coagulation (0.0335), and central nervous system (<i>p</i> = 0.0206) subscores. (4) Conclusions: These results suggested that patients with non-surgical sepsis may face distinct challenges and a higher risk of adverse outcomes compared to patients with sepsis following surgical intervention. These findings have important implications for clinical decision-making, patient management, and resource allocation in sepsis care.https://www.mdpi.com/2227-9059/11/8/2233sepsissurgical sepsisnon-surgical sepsismortalityorgan dysfunction |
| spellingShingle | Caspar Mewes Julius Runzheimer Carolin Böhnke Benedikt Büttner Marcus Nemeth José Hinz Michael Quintel Ashham Mansur Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients Biomedicines sepsis surgical sepsis non-surgical sepsis mortality organ dysfunction |
| title | Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients |
| title_full | Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients |
| title_fullStr | Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients |
| title_full_unstemmed | Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients |
| title_short | Differences in Mortality and Sepsis-Associated Organ Dysfunction between Surgical and Non-Surgical Sepsis Patients |
| title_sort | differences in mortality and sepsis associated organ dysfunction between surgical and non surgical sepsis patients |
| topic | sepsis surgical sepsis non-surgical sepsis mortality organ dysfunction |
| url | https://www.mdpi.com/2227-9059/11/8/2233 |
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