Influence of comorbidities and chronic medications on ICU mortality in sepsis: A population-based cohort study of 12,095 patients.
Source: PubMed, NCBI / U.S. National Library of Medicine
Sepsis patients are becoming progressively older and frailer and often require chronic medication. Comorbidities and long-term pharmacological treatments may influence survival outcomes in sepsis. This study aimed to evaluate the association between baseline health status, chronic medication use, and in-hospital mortality among ICU-admitted patients with sepsis. Retrospective population-based cohort study of ICU adult patients diagnosed with sepsis. The influence of baseline health status, measured using the adjusted morbidity groups (GMA) score, along with the effect of chronic medication use on post-sepsis survival was analysed. Pre-admission medication exposure was determined from outpatient prescription data for the eight months prior to admission. Multivariate logistic regression identified independent predictors of mortality. Twelve thousand ninety-five ICU-admitted patients with a diagnosis of sepsis were identified in the Catalan population database for 2018-2019. The cohort had a mean age of 68.2 years; high comorbidity burden (GMA: 33.2), high dependency on health services; and elevated baseline health expenditures. In 73.5% of cases infection was present at admission. The overall in-hospital mortality rate was 36.4%. Non-survivors exhibited higher comorbidity levels and greater medication use. In multivariate analysis, prior statin use was independently associated with reduced mortality (OR 0.794; 95% CI 0.723-0.872), whereas corticosteroids were linked to increase
Abstract
Sepsis patients are becoming progressively older and frailer and often require chronic medication. Comorbidities and long-term pharmacological treatments may influence survival outcomes in sepsis. This study aimed to evaluate the association between baseline health status, chronic medication use, and in-hospital mortality among ICU-admitted patients with sepsis. Retrospective population-based cohort study of ICU adult patients diagnosed with sepsis. The influence of baseline health status, measured using the adjusted morbidity groups (GMA) score, along with the effect of chronic medication use on post-sepsis survival was analysed. Pre-admission medication exposure was determined from outpatient prescription data for the eight months prior to admission. Multivariate logistic regression identified independent predictors of mortality. Twelve thousand ninety-five ICU-admitted patients with a diagnosis of sepsis were identified in the Catalan population database for 2018-2019. The cohort had a mean age of 68.2 years; high comorbidity burden (GMA: 33.2), high dependency on health services; and elevated baseline health expenditures. In 73.5% of cases infection was present at admission. The overall in-hospital mortality rate was 36.4%. Non-survivors exhibited higher comorbidity levels and greater medication use. In multivariate analysis, prior statin use was independently associated with reduced mortality (OR 0.794; 95% CI 0.723-0.872), whereas corticosteroids were linked to increased mortality (OR 1.321; 95% CI 1.108-1.575). Comorbidities and chronic medication use significantly influence sepsis survival. Statin use prior to admission was associated with reduced mortality, whereas corticosteroid use correlated with worse outcomes. The GMA score may enhance predictive models, improving resource allocation and clinical decision-making in hospitals. gov: NCT06354452.