title: Clinical Features, Short-Term Mortality, and Prognostic Risk Factors of Septic Patients Admitted to Internal Medicine Units: Results of an Italian Multicenter Prospective Study.
abstract: Only a few studies provided data on the clinical history of sepsis within internal Medicine units. The aim of the study was to assess the short-term mortality and to evaluate the prognostic risk factors in a large cohort of septic patients treated in internal medicine units. Thirty-one internal medicine units participated to the study. Within each participating unit, all admitted patients were screened for the presence of sepsis. A total of 533 patients were included; 78 patients (14.6%, 95%CI 11.9, 18.0%) died during hospitalization; mortality rate was 5.5% (95% CI 3.1, 9.6%) in patients with nonsevere sepsis and 20.1% (95%CI 16.2, 28.8%) in patients with severe sepsis or septic shock. Severe sepsis or septic shock (OR 4.41, 95%CI 1.93, 10.05), immune system weakening (OR 2.10, 95%CI 1.12, 3.94), active solid cancer (OR 2.14, 95% CI 1.16, 3.94), and age (OR 1.03 per year, 95% CI 1.01, 1.06) were significantly associated with an increased mortality risk, whereas blood culture positive for Escherichia coli was significantly associated with a reduced mortality risk (OR 0.46, 95%CI 0.24, 0.88). In-hospital mortality of septic patients treated in internal medicine units appeared similar to the mortality rate obtained in recent studies conducted in the ICU setting.
authors.affiliation: From the Internal Medicine Ward, Ospedale Civile, Legnano (AM, GB); Department of Clinical Medicine, Insubria University Varese (FD); Internal Medicine Hospital of La Spezia, La Spezia (MLR); Centre for Research on Health Economics, Social and Health Care Management-CREMS, University Carlo Cattaneo-LIUC, Castellanza (EF, EG); Internal Medicine Ward, Hospital Media Valle del Tevere, Todi (MG, PC); Microbiology Unit, Legnano Hospital, Legnano, Italy (PC), Italy; Infectious Diseases, Policlinico G.B. Rossi, University of Verona (EC); Internal Medicine Ward, Ospedale Niguarda Ca' Granda, Milan (FC); and Internal Medicine Ward, Ospedale Maggiore della Carità, Novara, Italy (MC).
authors.forename: Antonino
authors.initials: A
authors.lastname: Mazzone
authors.forename: Francesco
authors.initials: F
authors.lastname: Dentali
authors.forename: Micaela
authors.initials: M
authors.lastname: La Regina
authors.forename: Emanuela
authors.initials: E
authors.lastname: Foglia
authors.forename: Maurizia
authors.initials: M
authors.lastname: Gambacorta
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Garagiola
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bonardi
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Clerici
authors.forename: Ercole
authors.initials: E
authors.lastname: Concia
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Colombo
authors.forename: Mauro
authors.initials: M
authors.lastname: Campanini
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D013293:Enterococcus faecalis; D004927:Escherichia coli Infections / Q000150:complications*; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications*; D017052:Hospital Mortality; D006801:Humans; D007154:Immune System Diseases / Q000453:epidemiology*; D007388:Internal Medicine; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000382:microbiology / Q000401:mortality*; D012772:Shock, Septic / Q000382:microbiology / Q000401:mortality
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