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J Korean Soc Emerg Med > Volume 22(1); 2011 > Article
Journal of The Korean Society of Emergency Medicine 2011;22(1): 44-49.
Early Prognostic Factors of Patients with Septic Shock
Jae Seong Kim, Gil Joon Suh, Woon Yong Kwon, Jae Hyuk Lee, Kyung Su Kim, Myung Hee Park
Department of Emergency Medicine, Seoul National University College of Medicine, Korea. suhgil@snu.ac.kr
ABSTRACT
PURPOSE:
To identify prognostic factors during the first 6-hour period of therapy associated with the 28-day survival of patients with septic shock.
METHODS:
We enrolled consecutive patients admitted to the emergency intensive care unit with septic shock. According to the mortality within 28 days, enrolled patients were divided into survivor and non-survivor groups. We compared patients data obtained at 6 hours after therapy between the two groups. Multivariate analysis was performed to find prognostic factors during the first 6 hours of therapy that were associated with the 28-day survival.
RESULTS:
Among the 138 enrolled patients, 78 survived and 60 died. Amount of fluid which was infused during the first 6 hours of therapy (odds ratio (OR)=1.005; 95% CI, 1.002-1.008; p=0.002) and the Acute Physiology and Chronic Health Evaluation II (APACHE II) score (OR=0.859; 95% CI, 0.772-0.955; p=0.005) were independently associated with 28-day survival of patients with septic shock. Area under curve (AUC) of fluid volume for predicting 28-day survival was 0.940 (95% CI, 0.905-0.975) and the optimal cutoff value was 3000 mL. In the survival analysis, patients who received more than 3000 mL of fluid during the first 6 hours of therapy displayed a higher survival rate than patients receiving <3000 mL (p<0.001).
CONCLUSION:
The amount of fluid infused during the first 6 hours of therapy was independently associated with 28-day survival in patients with septic shock.
Key words: Patients, Septic Shock, Fluid therapy, Survival
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