Urosepsis 30-day mortality, morbidity, and their risk factors: SERPENS study, a prospective, observational multi-center study

Tendogdu, Zafer and Sofronievska Glavinov, Maja and Ristovski, Slobodan (2024) Urosepsis 30-day mortality, morbidity, and their risk factors: SERPENS study, a prospective, observational multi-center study. World Journal of Urology, 42 (1). p. 314. ISSN 1433-8726

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Abstract

Purpose
To provide a descriptive report of mortality and morbidity in the first 30 days of diagnosis of urosepsis. Secondary aim is to identify risk factors of unfavourable outcomes.

Methods
Prospective observational multicentre cohort study conducted from September 2014 to November 2018 in European hospitals. Adult patients (≥ 18 years) diagnosed with acute urosepsis according to Sepsis-2 criteria with confirmed microbiological infection were included. Outcomes were classified in one of four health states: death, multiple organ failure, single organ failure, and recovery at day 30 from onset of urosepsis. Descriptive statistics and ordinal logistic regression analysis was performed.

Results
Three hundred and fifty four patients were recruited, and 30-day mortality rate was 2.8%, rising to 4.6% for severe sepsis. All patients who died had a SOFA score of ≥ 2 at diagnosis. Upon initial diagnosis, 79% (n = 281) of patients presented with OF. Within 30 days, an additional 5% developed OF, resulting in a total of 84% affected. Charlson score (OR 1.14 CI 1.01–1.28), patients with respiratory failure at baseline (OR 2.35, CI 1.32–4.21), ICU admission within the past 12 months (OR 2.05, CI 1.00–4.19), obstruction causative of urosepsis (OR 1.76, CI 1.02–3.05), urosepsis with multi-drug-resistant(MDR) pathogens (OR 2.01, CI 1.15–3.53), and SOFA baseline score ≥ 2 (OR 2.74, CI 1.49–5.07) are significantly associated with day 30 outcomes (OF and death).

Conclusions
Impact of comorbidities and MDR pathogens on outcomes highlights the existence of a distinct group of patients who are prone to mortality and morbidity. These findings underscore the need for the development of pragmatic classifications to better assess the severity of UTIs and guide management strategies.

Item Type:	Article
Impact Factor Value:	3.4
Subjects:	Medical and Health Sciences > Clinical medicine Medical and Health Sciences > Health sciences
Divisions:	Faculty of Medical Science
Depositing User:	Maja Sofronievska
Date Deposited:	04 Jun 2024 10:30
Last Modified:	04 Jun 2024 10:30
URI:	https://eprints.ugd.edu.mk/id/eprint/34214

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