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2020, Number 4

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Rev Cub Med Int Emerg 2020; 19 (4)

Determination of variables associated with fatality in septic patients using logistic regression

Meriño MMA, Herrera CRE, Ocampo ARE

Language: Spanish
References: 30
Page: 1-19
PDF size: 320.16 Kb.


ABSTRACT

Introduction: Sepsis is defined as a pathophysiological state, characterized by a dysregulation of the host's immune response against a pathogen. The morbidity and mortality associated with this disease highly impact on the health of the population.
Objective: To identify the variables with the greatest statistical impact on the fatality of septic patients.
Methods: A retrospective cohort study was conducted. All the cases registered in the Critical Patients Unit at Herminda Martin Clinical Hospital with a clinical diagnosis of sepsis were considered during 2017. The sample consisted of 145 subjects. First, an inferential statistical model was developed for categorical variables where Pearson's Chi square was used; and ANOVA for continuous variables. sex, weight, age, infectious focus, presence of diabetes mellitus, mechanical ventilation, smoking, and previous illnesses were among the variables used for this analysis. Then, a logistic regression model was developed that made it possible to differentiate epidemiological variables associated with higher mortality in septic patients. To this model, to expand its predictive power, laboratory tests were added when the patient was admitted to the critical patient unit.
Results: The overall fatality of the cohort was 52 subjects, 35.9% of the sample. Regarding the body mass index (BMI), there were no significant differences between the groups studied. The generated model indicated that, with 95% confidence, the probability of dying increases between 76.3%, and 78.3% in male subjects with a primary intra-abdominal or respiratory infection focus, respectively. This probability rose to 100% with lactate of 80 mg/dL.
Conclusion: The variables with the highest incidence, associated with fatality, were male sex, having intra-abdominal or respiratory infectious focus, and having high lactate. Therefore, and taking into account that this was an exploratory study, these variables can be potentially useful for the development of a score. Keywords: sepsis; lethality; exploratory study; logistic regression.


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