Factors for predicting 28‐day mortality in older patients with suspected of having sepsis in the emergency department

Background Older patients face increased sepsis risk, requiring precise prognostic tools in the emergency department (ED). This study aimed to explore factors predicting 28‐day mortality among older (≥60 years) patients with suspicion of sepsis in the ED. Methods We performed a retrospective cohort...

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Published in:Hong Kong journal of emergency medicine 2024-06, Vol.31 (3), p.143-153
Main Authors: Sanguanwit, Pitsucha, Yuksen, Chaiyaporn, Khorana, Jiraporn, Phootothum, Yuranun, Damdin, Siriporn, Sutham, Krongkarn
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28‐day mortality
emergency department
older
predictive factors
sepsis
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container_issue 3
container_start_page 143
container_title Hong Kong journal of emergency medicine
container_volume 31
creator Sanguanwit, Pitsucha
Yuksen, Chaiyaporn
Khorana, Jiraporn
Phootothum, Yuranun
Damdin, Siriporn
Sutham, Krongkarn
description Background Older patients face increased sepsis risk, requiring precise prognostic tools in the emergency department (ED). This study aimed to explore factors predicting 28‐day mortality among older (≥60 years) patients with suspicion of sepsis in the ED. Methods We performed a retrospective cohort study. Data for all older patients with clinical suspected sepsis presenting to the ED from 1 October 2018 to 31 December 2018, were collected. Prognostic factors, characteristics, comorbidities, vital signs at triage, the emergency severity score, initial laboratory results, and sepsis bundle treatment were analyzed using univariable and multivariable Cox regression. Hazard ratios (HR) were calculated using these analytical methodologies to prognosticate 28‐day mortality. Results A total of 329 older patients with suspected sepsis were included. The overall 28‐day mortality was 10.33%. Independent prognostic factors that were significantly associated with 28‐day mortality were malignancy (adjusted hazard ratio [aHR]: 3.67; 95% confidence interval [CI]: 1.90, 7.09; p 
doi_str_mv 10.1002/hkj2.12023
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This study aimed to explore factors predicting 28‐day mortality among older (≥60 years) patients with suspicion of sepsis in the ED. Methods We performed a retrospective cohort study. Data for all older patients with clinical suspected sepsis presenting to the ED from 1 October 2018 to 31 December 2018, were collected. Prognostic factors, characteristics, comorbidities, vital signs at triage, the emergency severity score, initial laboratory results, and sepsis bundle treatment were analyzed using univariable and multivariable Cox regression. Hazard ratios (HR) were calculated using these analytical methodologies to prognosticate 28‐day mortality. Results A total of 329 older patients with suspected sepsis were included. The overall 28‐day mortality was 10.33%. Independent prognostic factors that were significantly associated with 28‐day mortality were malignancy (adjusted hazard ratio [aHR]: 3.67; 95% confidence interval [CI]: 1.90, 7.09; p &lt; 0.01), oxygen saturation ≤93% (aHR: 3.37; 95% CI: 1.79, 3.43; p &lt; 0.01), and dependent status (hazard ratio [HR]: 2.27; 95% CI: 1.14, 4.53; p = 0.02). Conclusions This study suggests that “MOD”; M‐Malignancy, O‐Oxygen saturation ≤93%, and D‐Dependent status are significant prognostic indicators for 28‐day mortality among older patients with suspected sepsis in the ED. Trial registration The trial was retrospectively registered in the Thai Clinical Trial Registry on 06/05/2022, identification number TCTR20220506006.</description><identifier>ISSN: 1024-9079</identifier><identifier>EISSN: 2309-5407</identifier><identifier>DOI: 10.1002/hkj2.12023</identifier><language>eng</language><publisher>Wiley</publisher><subject>28‐day mortality ; emergency department ; older ; predictive factors ; sepsis</subject><ispartof>Hong Kong journal of emergency medicine, 2024-06, Vol.31 (3), p.143-153</ispartof><rights>2024 The Authors. Hong Kong Journal of Emergency Medicine published by John Wiley &amp; Sons Australia, Ltd on behalf of Hong Kong College of Emergency Medicine Limited.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3343-e4db58c0c9b243af76cb6f9d63fa52e360cafb401bc2a3d42afc0e5c132c468f3</cites><orcidid>0009-0007-0794-8995 ; 0000-0002-4890-7176 ; 0000-0002-9818-4164 ; 0000-0002-2250-6980 ; 0000-0001-9023-0923</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fhkj2.12023$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fhkj2.12023$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,11562,27924,27925,46052,46476</link.rule.ids></links><search><creatorcontrib>Sanguanwit, Pitsucha</creatorcontrib><creatorcontrib>Yuksen, Chaiyaporn</creatorcontrib><creatorcontrib>Khorana, Jiraporn</creatorcontrib><creatorcontrib>Phootothum, Yuranun</creatorcontrib><creatorcontrib>Damdin, Siriporn</creatorcontrib><creatorcontrib>Sutham, Krongkarn</creatorcontrib><title>Factors for predicting 28‐day mortality in older patients with suspected of having sepsis in the emergency department</title><title>Hong Kong journal of emergency medicine</title><description>Background Older patients face increased sepsis risk, requiring precise prognostic tools in the emergency department (ED). This study aimed to explore factors predicting 28‐day mortality among older (≥60 years) patients with suspicion of sepsis in the ED. Methods We performed a retrospective cohort study. Data for all older patients with clinical suspected sepsis presenting to the ED from 1 October 2018 to 31 December 2018, were collected. Prognostic factors, characteristics, comorbidities, vital signs at triage, the emergency severity score, initial laboratory results, and sepsis bundle treatment were analyzed using univariable and multivariable Cox regression. Hazard ratios (HR) were calculated using these analytical methodologies to prognosticate 28‐day mortality. Results A total of 329 older patients with suspected sepsis were included. The overall 28‐day mortality was 10.33%. Independent prognostic factors that were significantly associated with 28‐day mortality were malignancy (adjusted hazard ratio [aHR]: 3.67; 95% confidence interval [CI]: 1.90, 7.09; p &lt; 0.01), oxygen saturation ≤93% (aHR: 3.37; 95% CI: 1.79, 3.43; p &lt; 0.01), and dependent status (hazard ratio [HR]: 2.27; 95% CI: 1.14, 4.53; p = 0.02). Conclusions This study suggests that “MOD”; M‐Malignancy, O‐Oxygen saturation ≤93%, and D‐Dependent status are significant prognostic indicators for 28‐day mortality among older patients with suspected sepsis in the ED. Trial registration The trial was retrospectively registered in the Thai Clinical Trial Registry on 06/05/2022, identification number TCTR20220506006.</description><subject>28‐day mortality</subject><subject>emergency department</subject><subject>older</subject><subject>predictive factors</subject><subject>sepsis</subject><issn>1024-9079</issn><issn>2309-5407</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>DOA</sourceid><recordid>eNp9kU1r3DAQhkVpoUuaS3-BzgGnow_b62MI-WoDvbRnMZZGu9p4V0ZSsviWn9Df2F9SO1t67FwGhud9GHgZ-yzgUgDIL9unnbwUEqR6x1ZSQVfVGtr3bCVA6qqDtvvIznPewTIt1B2s2PEWbYkpcx8THxO5YEs4bLhc_3795XDi-5gKDqFMPBx4HBzNGJZAh5L5MZQtz895JFvI8ej5Fl-WdKYxh7wkypY47Slt6GAn7mjEVPZz-BP74HHIdP53n7Gftzc_ru-rx-93D9dXj5VVSquKtOvrtQXb9VIr9G1j-8Z3rlEea0mqAYu-1yB6K1E5LdFboNoKJa1u1l6dsYeT10XcmTGFPabJRAzm7RDTxswfBTuQqXsr1ho7qcnruvX9LHVK6KaXNSpYXBcnl00x50T-n0-AWRowSwPmrYEZFif4GAaa_kOa-29f5SnzB3qfi24</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Sanguanwit, Pitsucha</creator><creator>Yuksen, Chaiyaporn</creator><creator>Khorana, Jiraporn</creator><creator>Phootothum, Yuranun</creator><creator>Damdin, Siriporn</creator><creator>Sutham, Krongkarn</creator><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>DOA</scope><orcidid>https://orcid.org/0009-0007-0794-8995</orcidid><orcidid>https://orcid.org/0000-0002-4890-7176</orcidid><orcidid>https://orcid.org/0000-0002-9818-4164</orcidid><orcidid>https://orcid.org/0000-0002-2250-6980</orcidid><orcidid>https://orcid.org/0000-0001-9023-0923</orcidid></search><sort><creationdate>202406</creationdate><title>Factors for predicting 28‐day mortality in older patients with suspected of having sepsis in the emergency department</title><author>Sanguanwit, Pitsucha ; Yuksen, Chaiyaporn ; Khorana, Jiraporn ; Phootothum, Yuranun ; Damdin, Siriporn ; Sutham, Krongkarn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3343-e4db58c0c9b243af76cb6f9d63fa52e360cafb401bc2a3d42afc0e5c132c468f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>28‐day mortality</topic><topic>emergency department</topic><topic>older</topic><topic>predictive factors</topic><topic>sepsis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sanguanwit, Pitsucha</creatorcontrib><creatorcontrib>Yuksen, Chaiyaporn</creatorcontrib><creatorcontrib>Khorana, Jiraporn</creatorcontrib><creatorcontrib>Phootothum, Yuranun</creatorcontrib><creatorcontrib>Damdin, Siriporn</creatorcontrib><creatorcontrib>Sutham, Krongkarn</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Wiley-Blackwell Open Access Backfiles (Open Access)</collection><collection>CrossRef</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Hong Kong journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sanguanwit, Pitsucha</au><au>Yuksen, Chaiyaporn</au><au>Khorana, Jiraporn</au><au>Phootothum, Yuranun</au><au>Damdin, Siriporn</au><au>Sutham, Krongkarn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors for predicting 28‐day mortality in older patients with suspected of having sepsis in the emergency department</atitle><jtitle>Hong Kong journal of emergency medicine</jtitle><date>2024-06</date><risdate>2024</risdate><volume>31</volume><issue>3</issue><spage>143</spage><epage>153</epage><pages>143-153</pages><issn>1024-9079</issn><eissn>2309-5407</eissn><abstract>Background Older patients face increased sepsis risk, requiring precise prognostic tools in the emergency department (ED). This study aimed to explore factors predicting 28‐day mortality among older (≥60 years) patients with suspicion of sepsis in the ED. Methods We performed a retrospective cohort study. Data for all older patients with clinical suspected sepsis presenting to the ED from 1 October 2018 to 31 December 2018, were collected. Prognostic factors, characteristics, comorbidities, vital signs at triage, the emergency severity score, initial laboratory results, and sepsis bundle treatment were analyzed using univariable and multivariable Cox regression. Hazard ratios (HR) were calculated using these analytical methodologies to prognosticate 28‐day mortality. Results A total of 329 older patients with suspected sepsis were included. The overall 28‐day mortality was 10.33%. Independent prognostic factors that were significantly associated with 28‐day mortality were malignancy (adjusted hazard ratio [aHR]: 3.67; 95% confidence interval [CI]: 1.90, 7.09; p &lt; 0.01), oxygen saturation ≤93% (aHR: 3.37; 95% CI: 1.79, 3.43; p &lt; 0.01), and dependent status (hazard ratio [HR]: 2.27; 95% CI: 1.14, 4.53; p = 0.02). Conclusions This study suggests that “MOD”; M‐Malignancy, O‐Oxygen saturation ≤93%, and D‐Dependent status are significant prognostic indicators for 28‐day mortality among older patients with suspected sepsis in the ED. 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subjects 28‐day mortality
emergency department
older
predictive factors
sepsis
title Factors for predicting 28‐day mortality in older patients with suspected of having sepsis in the emergency department
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