Source of infection affects hospital mortality in septic shock patients in the ICU

May 20, 2013

In ICU patients who have septic shock, the anatomic source of infection has a strong effect on the chances of survival, according to a new study from researchers in Canada.

"Understanding the local infection source in patients with may influence and ," said researcher Peter Dodek, MD MHSc, professor of at the University of British Columbia in Vancouver. "Accordingly, we examined the relationship between anatomic source of infection and hospital mortality in nearly 8,000 patients who had septic shock and who were admitted to ICUs in Canada, the United States and Saudi Arabia."

"We found that there are meaningful differences in hospital mortality among anatomic sites of infection in these patients."

The results of the study will be presented at the ATS 2013 International Conference.

This retrospective, multicenter, cohort study included 7,974 patients from 29 academic and . The researchers examined the relationship between 20 anatomic sources of infection and hospital survival, adjusting for predisposing factors including year and source of admission, age, sex, comorbidities, community- vs. hospital-acquired infection andandorganism type. They also adjusted for other potential mediating factors such as Acute Physiologic and Chronic (APACHE) II score, number of Day 1 organ failures, bacteremia, appropriateness of antibiotic treatment, and adjunct therapy.

After adjustment for these possible confounders, infections in eight anatomic sites were associated with significantly higher chances of survival compared to the lung, including genitourinary infections secondary to hydronephrosis and pyelonephritis, intra-abdominal infection secondary to cholecystitis/cholangitis and enterocolitis/diverticulitis, skin and soft tissue infection secondary to cellulitis/abscess/necrotizing fasciitis/decubitus ulcer, surgical site infection, intravascular catheter-related infection, and other infection sources. Infections related to hydronephrosis were associated with the highest chance of survival.

Infections in four anatomic sites were associated with significantly lower chances of survival (compared to lung): intra-abdominal infection secondary to ischemic bowel, disseminated infections, and central nervous system infections. Infections related to ischemic bowel were associated with the lowest chance of survival.

Further adjustment for the timing of initiation of did not significantly alter these relationships.

"Knowing that the source of infection can affect mortality in ICU patients who have septic shock may help guide treatment in these patients," said Dr. Dodek. "Further research should examine whether targeted treatment of the anatomic source of infection improves outcomes. In addition, these findings support stratification by anatomic source of infection of patients who are enrolled in clinical trials of sepsis treatments."

Explore further: Co-infections not associated with worse outcomes during H1N1 pandemic

Related Stories

Co-infections not associated with worse outcomes during H1N1 pandemic

April 9, 2013
A study at Rhode Island Hospital has found that despite complications, patients co-infected with the pandemic 2009-2010 influenza A H1N1 (pH1N1) and a second respiratory virus were not associated with worse outcomes or admission ...

Planning for bacteria in cancer patients may help hospitals fight infections

January 23, 2013
What cancerous conditions lead to what kinds of bacterial infections? If doctors knew, they could predict which patients would likely benefit from pre-treatment with certain kinds of antibiotics. A University of Colorado ...

Less commonly prescribed antibiotic may be better

August 16, 2012
The antibiotic most commonly prescribed to treat bloodstream infections in dialysis patients may not always be the best choice, according to a study appearing in an upcoming issue of the Journal of the American Society of ...

First proof of patient-to-nurse infection of coronavirus, WHO says

May 15, 2013
Two Saudi health workers have contracted the deadly coronavirus from patients, marking the first evidence of transmission in a hospital setting, the World Health Organization said Wednesday.

Infection rates unaffected by time to debridement of open fx

July 3, 2012
(HealthDay) -- There is no association between infection rates and time to operative debridement of open fractures, according to research published in the June 20 issue of The Journal of Bone & Joint Surgery.

Recommended for you

Aging impairs innate immune response to flu

December 13, 2017
Aging impairs the immune system's response to the flu virus in multiple ways, weakening resistance in older adults, according to a Yale study. The research reveals why older people are at increased risk of illness and death ...

Drug blocks Zika, other mosquito-borne viruses in cell cultures

December 12, 2017
If there was a Mafia crime family of the virus world, it might be flaviviruses.

Study seeks to aid diagnosis, management of catatonia

December 11, 2017
Catatonia, a syndrome of motor, emotional and behavioral abnormalities frequently characterized by muscular rigidity and a trance-like mental stupor and at times manifesting with great excitement or agitation, can occur during ...

New compound stops progressive kidney disease in its tracks

December 7, 2017
Progressive kidney diseases, whether caused by obesity, hypertension, diabetes, or rare genetic mutations, often have the same outcome: The cells responsible for filtering the blood are destroyed. Reporting today in Science, ...

New Lyme disease tests could offer quicker, more accurate detection

December 7, 2017
New tests to detect early Lyme disease - which is increasing beyond the summer months -could replace existing tests that often do not clearly identify the infection before health problems occur.

Spinal tap needle type impacts the risk of complications

December 6, 2017
The type of needle used during a lumbar puncture makes a significant difference in the subsequent occurrence of headache, nerve irritation and hearing disturbance in patients, according to a study by Hamilton medical researchers.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.