title: Mortality Risk Factors for Patients with Septic Shock after Implementation of the Surviving Sepsis Campaign Bundles.
abstract: BACKGROUND
  Septic shock remains a leading cause of death, despite advances in critical care management. The Surviving Sepsis Campaign (SSC) has reduced morbidity and mortality. This study evaluated risk factors for mortality in patients with septic shock who received treatment following the SSC bundles.
  
  
  METHODS
  This retrospective cohort study included patients with septic shock who received treatments following SSC bundles in an urban emergency department between November 2007 and November 2011. Primary and secondary endpoints were all-cause 7- and 28-day mortality.
  
  
  RESULTS
  Among 436 patients, 7- and 28-day mortality rates were 7.11% (31/436) and 14% (61/436), respectively. In multivariate analysis, high lactate level (odds ratio [OR], 1.286; 95% confidence interval [CI], 1.016-1.627; P=0.036) and low estimated glomerular filtration rate (OR, 0.953; 95% CI, 0.913-0.996; P=0.032) were independent risk factors for 7-day mortality. Risk factors for 28-day mortality were high lactate level (OR, 1.346; 95% CI, 1.083-1.673; P=0.008) and high Acute Physiology and Chronic Health Evaluation II score (OR, 1.153; 95% CI, 1.029-1.293; P=0.014).
  
  
  CONCLUSIONS
  The risk of mortality of septic shock patients remains high in patients with high lactate levels and acute kidney injury.
authors.affiliation: Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
authors.forename: Je Eun
authors.identifier: http://orcid.org/0000-0001-7056-6905
authors.initials: JE
authors.lastname: Song
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Moo Hyun
authors.initials: MH
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Woo Yong
authors.initials: WY
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: In Young
authors.initials: IY
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Oh
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong Chan
authors.initials: YC
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun Jin
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Su Jin
authors.initials: SJ
authors.lastname: Jeong
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Nam Su
authors.initials: NS
authors.lastname: Ku
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: June Myung
authors.initials: JM
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.|AIDS Research Institute, Yonsei University College of Medicine, Seoul, Korea. SERAN@yuhs.ac.
authors.forename: Jun Yong
authors.identifier: http://orcid.org/0000-0002-2775-3315
authors.initials: JY
authors.lastname: Choi
keywords: Mortality; Risk factors; Septic shock