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Comparative analyses of the impact of different criteria for sepsis diagnosis on outcome in patients with spontaneous subarachnoid hemorrhage

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Data on sepsis in patients with a subarachnoid hemorrhage (SAH) are scarce. We assessed the impact of different sepsis criteria on the outcome in an SAH cohort. Adult patients admitted to our ICU with a spontaneous SAH between 11/2014 and 11/2018 were retrospectively included. In patients developing...

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Main Authors: Centner, Franz-Simon (Author) , Oster, Mariella (Author) , Dally, Franz (Author) , Sauter-Servaes, Johannes (Author) , Pelzer, Tanja (Author) , Schöttler, Jochen (Author) , Hahn, Bianka (Author) , Fairley, Anna-Meagan (Author) , Abdulazim, Amr Nabil (Author) , Hackenberg, Katharina (Author) , Groden, Christoph (Author) , Etminan, Nima (Author) , Krebs, Jörg (Author) , Thiel, Manfred (Author) , Wenz, Holger (Author) , Maros, Máté E. (Author)
Format: Article (Journal)
Language:English
Published: 4 July 2022
In: Journal of Clinical Medicine
Year: 2022, Volume: 11, Issue: 13, Pages: 1-18
ISSN:2077-0383
DOI:10.3390/jcm11133873
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/jcm11133873
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Author Notes:Franz-Simon Centner, Mariella Eliana Oster, Franz-Joseph Dally, Johannes Sauter-Servaes, Tanja Pelzer, Jochen Johannes Schoettler, Bianka Hahn, Anna-Meagan Fairley, Amr Abdulazim, Katharina Antonia Margarete Hackenberg, Christoph Groden, Nima Etminan, Joerg Krebs, Manfred Thiel, Holger Wenz and Máté Elod Maros
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Summary:Data on sepsis in patients with a subarachnoid hemorrhage (SAH) are scarce. We assessed the impact of different sepsis criteria on the outcome in an SAH cohort. Adult patients admitted to our ICU with a spontaneous SAH between 11/2014 and 11/2018 were retrospectively included. In patients developing an infection, different criteria for sepsis diagnosis (Sepsis-1, Sepsis-3_original, Sepsis-3_modified accounting for SAH-specific therapy, alternative sepsis criteria compiled of consensus conferences) were applied and their impact on functional outcome using the modified Rankin Scale (mRS) on hospital discharge and in-hospital mortality was evaluated. Of 270 SAH patients, 129 (48%) developed an infection. Depending on the underlying criteria, the incidence of sepsis and septic shock ranged between 21-46% and 9-39%. In multivariate logistic regression, the Sepsis-1 criteria were not associated with the outcome. The Sepsis-3 criteria were not associated with the functional outcome, but in shock with mortality. Alternative sepsis criteria were associated with mortality for sepsis and in shock with mortality and the functional outcome. While Sepsis-1 criteria were irrelevant for the outcome in SAH patients, septic shock, according to the Sepsis-3 criteria, adversely impacted survival. This impact was higher for the modified Sepsis-3 criteria, accounting for SAH-specific treatment. Modified Sepsis-3 and alternative sepsis criteria diagnosed septic conditions of a higher relevance for outcomes in patients with an SAH.
Item Description:Gesehen am 15.08.2022
Physical Description:Online Resource
ISSN:2077-0383
DOI:10.3390/jcm11133873

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