A retrospective study of sepsis-associated encephalopathy: epidemiology, clinical features and adverse outcomes
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RESEARCH ARTICLE
Open Access
A retrospective study of sepsis-associated encephalopathy: epidemiology, clinical features and adverse outcomes Jiayi Chen1, Xiaobei Shi2, Mengyuan Diao1, Guangyong Jin1, Ying Zhu1, Wei Hu1* and Shaosong Xi1*
Abstract Background: Sepsis-associated encephalopathy (SAE) is a common complication of sepsis that may result in worse outcomes. This study was designed to determine the epidemiology, clinical features, and risk factors of SAE. Methods: This was a retrospective study of all patients with sepsis who were admitted to the Critical Care Medicine Department of Hangzhou First People’s Hospital Affiliated with Zhejiang University School of Medicine from January 2015 to December 2019. Results: A total of 291 sepsis patients were screened, and 127 (43.6%) were diagnosed with SAE. There were significant differences in median age, proportion of underlying diseases such as hypertension, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, gastrointestinal infections, detection rate of Enterococcus, and 28-day mortality between the SAE and non-SAE groups. Both the SOFA score and APACHE II score were independent risk factors for SAE in patients with sepsis. All 127 SAE patients were divided into survival and non-survival groups. The age, SOFA score, and APACHE II score were independently associated with 28-day mortality in SAE patients. Conclusion: In the present retrospective study, nearly half of patients with sepsis developed SAE, which was closely related to poor outcomes. Both the SOFA score and APACHE II score were independent risk factors for predicting the occurrence and adverse outcome of SAE. Keywords: Sepsis, Sepsis-associated encephalopathy, Retrospective study
Background Sepsis-associated encephalopathy (SAE) is a common complication of patients with sepsis and can manifest as mild disturbance of consciousness, disorientation, cognitive impairment, convulsion or deep coma [1, 2]. Importantly, SAE can result in dramatically poorer outcomes in patients with sepsis, with the mortality increasing with a rising SAE severity to a maximum of 70% [3]. Surviving SAE patients are likely to exhibit prolonged or permanent side effects, including altered behaviour, cognitive impairment, reduced
quality of life, or premature death [4]. To date, the diagnostic criteria and potential risk factors for SAE remain incompletely understood. Early identification, timely diagnosis and effective management may be important for the disease control in sepsis patients. The present study was therefore designed to explore the epidemiology, clinical characteristics and risk factors for SAE, as well as its adverse outcomes, via a retrospective study of 291 patients with sepsis.
Methods * Correspondence: [email protected]; [email protected] 1 Department of Critical Care Medicine, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, No.261, Huansha Road, Zhejiang 310006, Hangzhou, China Full list of author in
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