Einfluss chronischer Erkrankungen auf den Verlauf der Sepsis

Impact of chronic medical conditions on the clinical course of sepsis

by Evelyn Mulwande-Schad
Doctoral thesis
Date of Examination:2022-01-17
Date of issue:2022-01-13
Advisor:Prof. Dr. Ashham Mansur
Referee:Prof. Dr. Ashham Mansur
Referee:PD Dr. Jens Sperling
Persistent Address: http://dx.doi.org/10.53846/goediss-9036

 

 

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Abstract

English

According to previous studies, the clinical course of sepsis could be affected by preexisting medical conditions, which are very common among patients with sepsis. This observational study aimed at investigating whether common chronic medical conditions affect the 90-day mortality risk in adult Caucasian patients with sepsis. A total of 482 patients with sepsis were enrolled in this study. The ninety-day mortality was the primary outcome; organ failure was the secondary outcome. Sepsis-related organ failure assessment (SOFA) scores and the requirements for organ support were evaluated to assess organ failure. A multivariate Cox regression model for the association between the 90-day mortality risk and chronic preexisting medical conditions adjusted for all relevant confounders and mortality predictors revealed the highest hazard ratio for patients with chronic kidney disease (CKD) (hazard ratio, 2.25; 95% CI, 1.46-3.46; p = 0.0002). Patients with CKD had higher SOFA scores than patients without CKD (8.9 ± 4.0 and 6.5 ± 3.4, respectively; p < 0.0001). Additionally, an analysis of organ-specific SOFA scores revealed higher scores in three organ systems (kidney, cardiovascular and coagulation). Patients with CKD have the highest 90-day mortality risk compared with patients without CKD or with other chronic medical conditions.
Keywords: Sepsis; Chronic medical conditions; Chronic kidney disease; SOFA-Score
Schlagwörter: Sepsis; Chronische Erkrankungen; Chronische Niereninsuffizienz
 
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