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Cited 14 time in webofscience Cited 15 time in scopus
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Clinical outcome comparison of patients with septic shock defined by the new sepsis-3 criteria and by previous criteria

Authors
Ryoo, Seung MokKang, Gu HyunShin, Tae GunHwang, Sung YeonKim, KyuseokJo, You HwanPark, Yoo SeokChoi, Sung-HyukYoon, Young HoonKwon, Woon YongSuh, Gil JoonLim, Tae HoHan, Kap SuChoi, Han SungChung, Sung PhilKim, Won Young
Issue Date
Feb-2018
Publisher
Pioneer Bioscience Publishing Company (PBPC)
Keywords
Sepsis; shock; mortality; prognosis
Citation
Journal of Thoracic Disease, v.10, no.2, pp 845 - 853
Pages
9
Indexed
SCIE
SCOPUS
Journal Title
Journal of Thoracic Disease
Volume
10
Number
2
Start Page
845
End Page
853
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/3913
DOI
10.21037/jtd.2018.01.96
ISSN
2072-1439
2077-6624
Abstract
Background: We compared the clinical characteristics and outcomes between the new definition of sepsis-3 septic shock and the definition previously used from 1991 until recently. Methods: We conducted an observational study using a prospective, multi-center registry of septic shock from October 2015 to February 2017. Registry data were collected by 10 emergency departments (EDs) in tertiary hospitals that are members of the Korean Shock Society. Data on septic shock patients who met the previous septic shock definition were collected. The patients were divided into a sepsis-3 defined septic shock group, made up of those who met the new criteria for refractory hypotension with hyperlactatemia, and a group of those who met only the 1991 definition for septic shock. The primary outcome was 90-day mortality, and secondary outcomes were 28-day mortality and in-hospital mortality. Results: Of all 1,028 included patients, 574 (55.8%) met the septic shock criteria for sepsis-3, leaving 454 patients who met only the previous definition. Those who met the sepsis-3 criteria demonstrated higher comorbidity than those who met the previous definition (83.1% vs. 75.3%, P<0.01), but there was no difference in infection focus. The sequential organ failure assessment (SOFA) (initial/maximal), the acute physiology, and the chronic health evaluation II scores were significantly higher in for those who met the sepsis-3 criteria [6.5 +/- 3.1 vs. 5.0 +/- 2.9, 9.3 +/- 3.8 vs. 6.6 +/- 3.4, and 20.0 (15.0-26.0) vs. 15.0 (10.0-20.3), respectively; P<0.01]. The 90-day mortality was significantly higher in the sepsis-3 group (32.1% vs. 23.3%; P<0.01). In-hospital and 28-day mortality were also higher in the sepsis-3 group (26.8% vs. 17.1% and 25.1% vs. 16.5%, respectively; P<0.01). Conclusions: The new definition of septic shock successfully selected patients with greater severities and worse outcomes.
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