Sepsis in a Combined Medical and Surgical High Dependency/Intensive Care Unit in Singapore: A Cohort Study and Survival Analysis

Figures & data

Figure 1 Study algorithm.

Table 1 Demographic Data of Sepsis Patients with Group Comparison

	Total N = 254	Septic Shock N = 141	Sepsis without Shock N = 113	P value	30-Day Survivor N = 205	30-Day Non-survivor N = 49	P value
^aAge	64 (16–90)	66 (16–90)	63 (25–87)	<0.001	63 (22–90)	70 (16–90)	<0.001
Male (%)	154 (60.6%)	90 (63.8%)	64 (56.6%)	0.248	124 (60.5%)	30 (61.2%)	0.53
Race
Chinese	145 (57%)	79 (56%)	66 (58.4%)	P>0.05	117 (57.1%)	28 (57.1%)	P>0.05
Malay	51 (20%)	31 (22%)	20 (17.7%)		39 (19%)	12 (24.5%)
Indian	26 (10%)	14 (9.9%)	12 (10.6%)		22 (10.7%)	4 (8.2%)
Others	32 (13%)	17 (12.1%)	15 (13.3%)		27 (13.2%)	5 (10.2%)
Past medical history
Ischemic heart disease	59 (23%)	37 (26.6%)	22 (19.6%)	0.232	44 (21.7%)	15 (31.3%)	0.113
Cirrhosis	7 (3%)	3 (2.1%)	4 (3.5%)	0.703	6 (2.9%)	1 (2.0%)	0.595
Dialysis	28 (11%)	18 (12.8%)	10 (8.8%)	0.421	20 (9.8%)	8 (16.3%)	0.144
Diabetes Mellitus	105 (41%)	58 (41.1%)	47 (41.6%)	0.521	82 (40%)	23 (46.9%)	0.234
Hypertension	147 (58%)	88 (62.4%)	59 (52.2%)	0.125	113 (55.1%)	34 (69.4%)	0.048
Chronic Lung disease	46 (18%)	15 (10.6%)	31 (27.4%)	<0.001	39 (19%)	7 (14.3%)	0.292
Immunocompromised host	9 (4%)	5 (3.6%)	4 (3.5%)	0.631	6 (2.9%)	3 (6.3%)	0.232

Note: ^aPresented as median (Min-Max).

Table 2 Clinical Data of Sepsis Patients with Group Comparison

	Total N = 254	Septic Shock N = 141	Sepsis without Shock N = 113	P value	30 Day Survivor N = 205	30 Day Non-Survivor N = 49	P value
Site of infection
Lung	106 (42%)	48 (34.0%)	58 (51.3%)	P<0.05	74 (36.1%)	32 (65.3%)	P<0.05
Abdomen	69 (27%)	44 (31.2%)	25 (22.1%)	P >0.05	60 (29.3%)	9 (18.4%)	P >0.05
Urinary tract	36 (14%)	20 (14.2%)	16 (14.2%)	P>0.05	33 (16.1%)	3 (6.1%)	P >0.05
Soft tissue	28 (11%)	21 (14.9%)	7 (6.2%)	P<0.05	24 (11.7%)	4 (8.2%)	P >0.05
Others	15 (6%)	8 (5.7%)	7 (6.2%)	P>0.05	14 (6.8%)	1 (2%)	P >0.05
^aLength of stay before ICU admission (day)	0 (0–58)	0 (0–58)	0 (0–29)	0.403	0 (0–53)	0 (0–58)	0.001
qSOFA >1	83 (32.6%)	56 (39.7%)	27 (23.9%)	0.01	61 (29.8%)	22 (44.9%)	0.033
^aSOFA score at ICU-admission	6 (2–17)	9 (2–17)	4 (2–9)	<0.001	5 (2–17)	9 (2–16)	<0.001
Invasive Mechanical Ventilation	89 (35%)	74 (52.5%)	15 (13.3%)	<0.001	55 (26.8%)	34 (69.4%)	<0.001
Positive blood culture	88 (34.6%)	56 (39.7%)	32 (28.3%)	0.038	73 (35.6%)	15 (30.6%)	0.314
^aICU Length of stay (day)	3 (1–35)	3 (1–35)	2 (1–14)	<0.001	3 (1–35)	4 (1–27)	0.037
Care Limitation/withdraw	19 (7.5%)	13 (9.2%)	6 (5.3%)	0.338
Unplanned ICU readmission	17 (6.7%)	12 (8.5%)	5 (4.4%)	0.218
30-day mortality	49 (19.3%)	39 (27.6%)	10 (8.8%)	<0.001
1-year mortality	64 (25.2%)	49 (34.8%)	15 (13.3%)	<0.001
2-year mortality	77 (30.3%)	56 (39.7%)	21 (18.6%)	<0.001
3-year mortality	82 (32.3%)	59 (41.8%)	23 (20.4%)	<0.001

Note: ^aPresented as median (Min-Max).

Abbreviations: ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment score; qSOFA, quick Sequential Organ Failure Assessment score.

Figure 2 3-year survival plot comparing septic shock and sepsis without shock group.

Table 3 COX Regression Analysis for 30-Day Mortality

	HR	95% CI	P value
Age	1.028	1.005–1.051	0.010
Immunocompromised host	5.254	1.495–28.464	0.01
Lung infection	4.802	2.567–8.982	<0.001
Septic shock	2.054	0.837 −5.037	0.116
SOFA score at ICU admission	1.206	1.094–1.329	<0.001

Abbreviations: ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment score; HR, hazard ratio; CI, confidence interval.

Table 4 Cox Regression for 3-Year Mortality in 30-Day Survivors

	HR	95% CI	P value
Liver cirrhosis	4.493	0.992–20.359	0.051
Diabetes mellitus	2.562	1.209–5.431	0.014
Septic shock	2.348	0.883–6.245	0.087
Lung infection	3.411	1.615–7.202	0.001
ICU admission qSOFA>1	2.940	1.373–6.296	0.006
ICU admission SOFA score	0.89	0.761–1.040	0.142
Unplanned ICU readmission	5.251	2.166–12.729	<0.001

Abbreviations: ICU, intensive care unit; SOFA, Sequential Organ Failure Assessment score; qSOFA, quick Sequential Organ Failure Assessment score; HR, hazard ratio; CI, confidence interval.