Chronic kidney disease is associated with a higher 90-day mortality than other chronic medical conditions in patients with sepsis

Ashham Mansur, Evelyn Mulwande, Maximilian Steinau, Ingo Bergmann, Aron Frederik Popov, Michael Ghadimi, Tim Beissbarth, Martin Bauer, José Hinz, Ashham Mansur, Evelyn Mulwande, Maximilian Steinau, Ingo Bergmann, Aron Frederik Popov, Michael Ghadimi, Tim Beissbarth, Martin Bauer, José Hinz

Abstract

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.

Figures

Figure 1
Figure 1
The Kaplan–Meier curves demonstrating survival were censored at day 90 for patients with CKD and patients without CKD. The mortality risk among the patients in the study was higher in the patients with CKD compared with the patients without CKD (p 

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