title: Chronic kidney disease is associated with a higher 90-day mortality than other chronic medical conditions in patients with sepsis.
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.
authors.affiliation: Department of Anesthesiology, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: Ashham
authors.initials: A
authors.lastname: Mansur
authors.affiliation: Department of Anesthesiology, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Mulwande
authors.affiliation: Department of Anesthesiology, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Steinau
authors.affiliation: Department of Anesthesiology, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: Ingo
authors.initials: I
authors.lastname: Bergmann
authors.affiliation: Department of Cardiothoracic Transplantation &Mechanical Support, Royal Brompton and Harefield Hospital, Harefield, Hill End Road, UB9 6JH London, United Kingdom.
authors.forename: Aron Frederik
authors.initials: AF
authors.lastname: Popov
authors.affiliation: Department of General and Visceral Surgery, University Medical Center, Georg August University, D-37075 Goettingen, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ghadimi
authors.affiliation: Department of Medical Statistics, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Beissbarth
authors.affiliation: Department of Anesthesiology, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Department of Anesthesiology, University Medical Center, Georg August University, Robert-Koch-Str.40, D-37075 Goettingen, Germany.
authors.forename: José
authors.initials: J
authors.lastname: Hinz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000209:etiology; D016016:Proportional Hazards Models; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality / Q000473:pathology*; D012307:Risk Factors; D018805:Sepsis / Q000150:complications*; D012720:Severity of Illness Index; D055815:Young Adult