Early Prognostic Factors of Patients with Septic Shock

ABSTRACT

PURPOSE: To identify prognostic factors during the first 6-hour period of therapy associated with the 28-day survival of patients with septic shock. METHODS: We enrolled consecutive patients admitted to the emergency intensive care unit with septic shock. According to the mortality within 28 days, enrolled patients were divided into survivor and non-survivor groups. We compared patients data obtained at 6 hours after therapy between the two groups. Multivariate analysis was performed to find prognostic factors during the first 6 hours of therapy that were associated with the 28-day survival. RESULTS: Among the 138 enrolled patients, 78 survived and 60 died. Amount of fluid which was infused during the first 6 hours of therapy (odds ratio (OR)=1.005; 95% CI, 1.002-1.008; p=0.002) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR=0.859; 95% CI, 0.772-0.955; p=0.005) were independently associated with 28-day survival of patients with septic shock. Area under curve (AUC) of fluid volume for predicting 28-day survival was 0.940 (95% CI, 0.905-0.975) and the optimal cutoff value was 3000 mL. In the survival analysis, patients who received more than 3000 mL of fluid during the first 6 hours of therapy displayed a higher survival rate than patients receiving <3000 mL (p<0.001). CONCLUSION: The amount of fluid infused during the first 6 hours of therapy was independently associated with 28-day survival in patients with septic shock.