Incidence, risk factors and impact on outcomes of secondary infection in patients with septic shock: an 8-year retrospective study

• Published in: Scientific reports 2016-12, Vol.6 (1), p.38361-38361, Article 38361
• Main Authors: Zhao, Guang-ju, Li, Dong, Zhao, Qian, Song, Jia-xing, Chen, Xiao-rong, Hong, Guang-liang, Li, Meng-fang, Wu, Bing, Lu, Zhong-qiu
• Format: Article
• Language: English
• Subjects: 692/308; 692/499; Aged; APACHE; Coinfection; Critical Illness; Female; Gram-Negative Bacterial Infections - diagnosis; Gram-Negative Bacterial Infections - microbiology; Gram-Negative Bacterial Infections - mortality; Gram-Negative Bacterial Infections - pathology; Gram-Positive Bacterial Infections - diagnosis; Gram-Positive Bacterial Infections - microbiology; Gram-Positive Bacterial Infections - mortality; Gram-Positive Bacterial Infections - pathology; Hospital Mortality - trends; Humanities and Social Sciences; Humans; Infections; Intensive Care Units; Intubation; Intubation, Intratracheal - mortality; Length of Stay - statistics & numerical data; Logistic Models; Male; Middle Aged; Mortality; multidisciplinary; Proportional Hazards Models; Retrospective Studies; Risk Factors; Science; Secondary infection; Sepsis; Septic shock; Shock, Septic - diagnosis; Shock, Septic - microbiology; Shock, Septic - mortality; Shock, Septic - pathology; Statistical analysis; Survival Analysis
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/srep38361

Secondary infection in septic patients has received widespread attention, although clinical data are still lacking. The present study was performed on 476 patients with septic shock. Time trends for mortality were analyzed using Spearman’s rank correlation test. Risk factors for secondary infection were investigated by binary logistic regression. The extended Cox model with time-varying covariates and hazard ratios (HR) was performed to determine the impact of secondary infection on mortality. Differences in hospital length of stay (LOS) between patients with and without secondary infection were calculated using a multistate model. Thirty-nine percent of septic shock patients who survived the early phase of the disease developed secondary infection. There was a statistically significant increased odds ratio for secondary infection in older patients and patients with a longer LOS in the intensive care unit (ICU), a higher Sequential Organ Failure Assessment (SOFA) score, and endotracheal intubation. Secondary infection significantly reduced the rate of discharge (HR 5.607; CI 95 3.612–8.704; P