Comparing Long-Term Prognosis in Chronic Critically Ill Patients: A Case Series Study of Medical versus Surgical Sepsis
Abstract
:1. Introduction
2. Methods
2.1. Case Series Description
2.2. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristics | RAP (n = 5) | CCI (n = 7) | Early Death (n = 5) | p * | p ** |
---|---|---|---|---|---|
Male, n (%) | 3 (60) | 5 (71) | 2 (40) | 0.55 | 0.68 |
Age in years, mean ± SD | 74.4 ± 16.6 | 69.7 ± 5.8 | 56.6 ± 22.3 | 0.18 | 0.66 |
Age ≥ 65 years, n (%) | 5 (100.0) | 6 (85.7) | 3 (60.0) | 0.24 | 0.29 |
BMI, median (25th, 75th percentiles) | 25.0 (23.0, 43.2) | 35.3 (27.5, 42.7) | 33.0 (27.0, 37.4) | 0.88 | 0.68 |
Charlson comorbidity index score, mean ± SD | 5.2 ± 1.5 | 5.43 ± 2.67 | 5.8 ± 3.93 | 0.96 | 0.78 |
APACHE II score, mean ± SD | 26 ± 9.4 | 21.9 ± 7.2 | 24.2 ± 4.3 | 0.63 | 0.95 |
SOFA score, mean ± SD | 9 ± 2.8 | 8.7 ± 3.6 | 11.6 ± 4.2 | 0.42 | 0.95 |
Septic shock, n (%) | 2 (40) | 2 (28.6) | 4 (80) | 0.20 | 0.68 |
Sepsis source: | |||||
- abdominal, n (%) | 1 (20) | 2 (28.6%) | 0 (0) | 0.43 | 0.74 |
- lung, n (%) | 1 (20) | 4 (57.1) | 2 (40) | 0.43 | 0.20 |
- other, n (%) | 3 (60) | 1 (14.3) | 3 (60) | 0.17 | 0.10 |
Characteristics | RAP (n = 30) | CCI (n = 31) | Early Death (n = 21) | p * | p ** |
---|---|---|---|---|---|
Male, n (%) | 19 (63) | 17 (55) | 12 (57) | 0.79 | 0.50 |
Age in years, mean ± SD | 60.5 ± 16.9 | 60.4 ± 16.3 | 62.5 ± 17.6 | 0.89 | 0.99 |
Age ≥ 65 years, n (%) | 17 (56.7) | 12 (38.7) | 13 (61.9) | 0.20 | 0.16 |
BMI, median (25th, 75th percentiles) | 30.2 (22.6, 35.5) | 32.9 (27.1, 39.8) | 28.4 (22.5, 39.0) | 0.48 | 0.19 |
Charlson comorbidity index score, mean ± SD | 3.6 ± 2.4 | 4.6 ± 3.2 | 5.3 ± 3.3 | 0.08 | 0.06 |
APACHE II score, mean ± SD | 25.9 ± 7.0 | 28.2 ± 8.9 | 31.4 ± 7.9 | 0.07 | 0.29 |
SOFA score, mean ± SD | 8.9 ± 3.8 | 12.0 ± 3.6 | 11.8 ± 3.4 | 0.0023 | 0.0017 |
Septic shock, n (%) | 7 (23.3) | 10 (32.3) | 10 (47.6) | 0.19 | 0.44 |
Sepsis source: | |||||
- abdominal, n (%) | 2 (6.5) | 8 (25.8) | 4 (19.1) | 0.13 | 0.04 |
- lung, n (%) | 20 (66.7) | 18 (58.1) | 13 (61.9) | 0.79 | 0.49 |
- other, n (%) | 8 (26.7) | 5 (16.1) | 4 (19.1) | 0.58 | 0.05 |
Short-Term Outcomes | Surgical CCI (n = 7) | Medical CCI (n = 21) | p-Value |
---|---|---|---|
28-day mortality, n (%) | 3 (42.9) | 16 (51.6) | 0.68 |
ICU-free days within first 28 days, median (25th, 75th percentiles) | 5.0 (3.5, 9.5) | 0 (0, 6.0) | 0.04 |
ICU mortality, n (%) | 3 (42.9) | 15 (48.4) | 0.79 |
Hospital LOS, median (25th, 75th percentiles) | 23 (16, 28) | 24 (20, 35) | 0.30 |
Ventilator-free days *, median (25th, 75th percentiles) | 21 (11,24) | 3 (0, 12.5) | 0.0039 |
28-day readmission, n (%) | 2 (28.6) | 4 (12.9) | 0.30 |
SOFA score at day 14, mean ± SD | 4.3 ± 2.7 | 8.0 ± 3.9 | <0.0001 |
AKI, n (%) | 4 (57.1) | 18 (58.1) | 0.96 |
Discharge disposition, n (%): | |||
- Discharged home | 1 (14.2) | 3 (9.7) | 0.72 |
- Long-term acute care facility | 2 (28.6) | 5 (16.1) | 0.44 |
- Skilled nursing facility | 0 (0) | 2 (6.5) | 0.49 |
- Hospice care | 1 (14.2) | 2 (6.5) | 0.49 |
One-Year Outcomes | Surgical CCI (n = 7) | Medical CCI (n = 21) | p-Value |
---|---|---|---|
Mortality, n (%) | 3 (42.9) | 21 (67.7) | 0.22 |
Zubrod/ECOG score, mean ± SD | 3.0 ± 2.2 | 4.0 ± 1.7 | 0.88 |
Current residence, n (%): | |||
- Home | 4 (57.1) | 8 (25.8) | 0.11 |
- Long-term acute care facility | 0 | 1 (3.2) | 0.63 |
- Skilled nursing facility | 0 | 0 | - |
- Hospice care | 0 | 0 | - |
Mortality | Odds Ratio | Std. Err. | z | P.|z| | 95% Conf. Interval | |
---|---|---|---|---|---|---|
Surgical vs. Medical | 4.20 | 5.00 | 1.21 | 0.228 | 0.41 | 43.36 |
Age | 0.97 | 0.03 | −0.85 | 0.395 | 0.91 | 1.04 |
APACHE II | 0.91 | 0.06 | −1.39 | 0.164 | 0.80 | 1.04 |
Charlson comorbidity index | 0.82 | 0.14 | −1.13 | 0.259 | 0.58 | 1.16 |
Septic shock | 1.74 | 1.93 | 0.50 | 0.619 | 0.20 | 15.36 |
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Mancini, B.; Liu, J.; Samuelsen, A.; Howrylak, J.A.; Schultz, L.; Bonavia, A.S. Comparing Long-Term Prognosis in Chronic Critically Ill Patients: A Case Series Study of Medical versus Surgical Sepsis. Medicina 2023, 59, 1617. https://doi.org/10.3390/medicina59091617
Mancini B, Liu J, Samuelsen A, Howrylak JA, Schultz L, Bonavia AS. Comparing Long-Term Prognosis in Chronic Critically Ill Patients: A Case Series Study of Medical versus Surgical Sepsis. Medicina. 2023; 59(9):1617. https://doi.org/10.3390/medicina59091617
Chicago/Turabian StyleMancini, Benjamin, Jiabin Liu, Abigail Samuelsen, Judie A. Howrylak, Lisa Schultz, and Anthony S. Bonavia. 2023. "Comparing Long-Term Prognosis in Chronic Critically Ill Patients: A Case Series Study of Medical versus Surgical Sepsis" Medicina 59, no. 9: 1617. https://doi.org/10.3390/medicina59091617