Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study
Abstract Background Autoimmune diseases (ADs) may be complicated by sepsis when intensive care unit (ICU) admission. But repeated sepsis among AD patients has not been studied yet. The aim of this study is to investigate the impact of repeated in-ICU sepsis on the 1-year overall-cause mortality, sep...
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| Format: | Article |
| Language: | English |
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BMC
2024-02-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-024-09072-y |
| _version_ | 1797275711609765888 |
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| author | Jinming Yang Jie Chen Min Zhang Qingsa Zhou Bing Yan |
| author_facet | Jinming Yang Jie Chen Min Zhang Qingsa Zhou Bing Yan |
| author_sort | Jinming Yang |
| collection | DOAJ |
| description | Abstract Background Autoimmune diseases (ADs) may be complicated by sepsis when intensive care unit (ICU) admission. But repeated sepsis among AD patients has not been studied yet. The aim of this study is to investigate the impact of repeated in-ICU sepsis on the 1-year overall-cause mortality, septic shock and in-ICU death of AD patients. Methods Data of AD patients with sepsis retrieved from Medical Information Mart for Intensive Care IV (MIMIC-IV) database were divided into the single group and the repeated group according to the frequency of in-ICU sepsis. Propensity score matching was used to balance inter-group bias. Cox proportional hazard regression and sensitivity analysis were utilized to assess the variables on mortality. Results The incidence of repeated in-ICU sepsis in baseline was 19.8%. The repeated in-ICU sepsis was a risk factor for 1-year overall-cause mortality among AD patients (adjusted hazard ratio [HR] = 1.50, 95% CI: 1.16–1.93, P = 0.002), with robust adjusted HRs by the adjustment for confounders in the sensitivity analysis (all P < 0.01). Maximum Sequential Organ Failure Assessment (Max SOFA), Charlson comorbidity index (CCI) and Simplified Acute Physiology Score-II (SAPS-II) were risk factors for 1-year overall-cause mortality among AD with repeated sepsis (Max SOFA: HR = 1.09, P = 0.002; CCI: HR = 1.08, P = 0.039; SAPS-II: HR = 1.03, P < 0.001). Conclusions Compared to single hit, repeated in-ICU sepsis was independently related to a higher risk of 1-year overall-cause mortality among AD patients. Assessment tools (Higher SOFA, CCI and SAPS-II scores) were closely linked to poor prognosis of AD with repeated sepsis and helped to reflect ill physical conditions for the patients. |
| first_indexed | 2024-03-07T15:18:25Z |
| format | Article |
| id | doaj.art-c8fe063ce9a545f7bcdfbff8f52107ed |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-03-07T15:18:25Z |
| publishDate | 2024-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-c8fe063ce9a545f7bcdfbff8f52107ed2024-03-05T17:48:50ZengBMCBMC Infectious Diseases1471-23342024-02-0124111110.1186/s12879-024-09072-yPrognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort studyJinming Yang0Jie Chen1Min Zhang2Qingsa Zhou3Bing Yan4Department of Rheumatology and Immunology, West China Hospital, Sichuan UniversityDepartment of Rheumatology, People’s Hospital of LeshanDepartment of Rheumatology and Immunology, West China Hospital, Sichuan UniversityDepartment of Rheumatology and Immunology, West China Hospital, Sichuan UniversityDepartment of Rheumatology and Immunology, West China Hospital, Sichuan UniversityAbstract Background Autoimmune diseases (ADs) may be complicated by sepsis when intensive care unit (ICU) admission. But repeated sepsis among AD patients has not been studied yet. The aim of this study is to investigate the impact of repeated in-ICU sepsis on the 1-year overall-cause mortality, septic shock and in-ICU death of AD patients. Methods Data of AD patients with sepsis retrieved from Medical Information Mart for Intensive Care IV (MIMIC-IV) database were divided into the single group and the repeated group according to the frequency of in-ICU sepsis. Propensity score matching was used to balance inter-group bias. Cox proportional hazard regression and sensitivity analysis were utilized to assess the variables on mortality. Results The incidence of repeated in-ICU sepsis in baseline was 19.8%. The repeated in-ICU sepsis was a risk factor for 1-year overall-cause mortality among AD patients (adjusted hazard ratio [HR] = 1.50, 95% CI: 1.16–1.93, P = 0.002), with robust adjusted HRs by the adjustment for confounders in the sensitivity analysis (all P < 0.01). Maximum Sequential Organ Failure Assessment (Max SOFA), Charlson comorbidity index (CCI) and Simplified Acute Physiology Score-II (SAPS-II) were risk factors for 1-year overall-cause mortality among AD with repeated sepsis (Max SOFA: HR = 1.09, P = 0.002; CCI: HR = 1.08, P = 0.039; SAPS-II: HR = 1.03, P < 0.001). Conclusions Compared to single hit, repeated in-ICU sepsis was independently related to a higher risk of 1-year overall-cause mortality among AD patients. Assessment tools (Higher SOFA, CCI and SAPS-II scores) were closely linked to poor prognosis of AD with repeated sepsis and helped to reflect ill physical conditions for the patients.https://doi.org/10.1186/s12879-024-09072-yAutoimmune diseaseRepeated sepsisCritical carePrognosis |
| spellingShingle | Jinming Yang Jie Chen Min Zhang Qingsa Zhou Bing Yan Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study BMC Infectious Diseases Autoimmune disease Repeated sepsis Critical care Prognosis |
| title | Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study |
| title_full | Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study |
| title_fullStr | Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study |
| title_full_unstemmed | Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study |
| title_short | Prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients: a retrospective cohort study |
| title_sort | prognostic impacts of repeated sepsis in intensive care unit on autoimmune disease patients a retrospective cohort study |
| topic | Autoimmune disease Repeated sepsis Critical care Prognosis |
| url | https://doi.org/10.1186/s12879-024-09072-y |
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