A systematic review on risk factors associated with sepsis in patients admitted to intensive care units

Fathi, Mohammad; Markazi-Moghaddam, Nader; Ramezankhani, Azra

doi:10.1016/j.aucc.2018.02.005

Cited by 37 publications

(27 citation statements)

References 54 publications

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“…The preventive approach would require identification of patients at increased risk of sepsis. A number of sepsis risk factors have been pinpointed (reviewed, e.g., by Fathi et al .…”

Section: Potential Clinical Relevance Of Nod‐tlr Synergymentioning

confidence: 99%

“…88 Interestingly, the augmenting effect of BCG on monocyte cytokine responses appears to be mediated via NOD2. 86 In this case, BCG-induced training can be interpreted as a particular case of positive NOD-TLR interaction, whereby the first stimulus Fathi et al 91 ), and some studies propose multiparametric prognostic classifiers to identify high-risk patients. 92,93 It is then a matter of clinical trials to determine whether stimulation of innate immunity in these patients would reduce sepsis risk.…”

Section: Prevention Of Infectious Diseasesmentioning

confidence: 99%

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Synergistic interactions between NOD receptors and TLRs: Mechanisms and clinical implications

Pashenkov

Murugina

Будихина

et al. 2018

Journal of Leukocyte Biology

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Interactions between pattern recognition receptors (PRRs) shape innate immune responses to particular classes of pathogens. Here, we review interactions between TLRs and nucleotide‐binding oligomerization domain 1 and 2 (NOD1 and NOD2) receptors, two major groups of PRRs involved in innate recognition of bacteria. Most of experimental data both in vitro and in vivo suggest that NODs and TLRs synergize with each other at inducing the production of cytokines and antimicrobial peptides. Molecular mechanisms of this synergy remain poorly understood, although several scenarios can be proposed: (i) direct interactions of signaling pathways downstream of NODs and TLRs; (ii) mutual transcriptional regulation of unique components of NOD‐dependent and TLR‐dependent signaling pathways; and (iii) interactions at the post‐transcriptional level. Potential practical implications of NOD‐TLR synergy are dual. In sepsis, where synergistic effects probably contribute to excessive proinflammatory cytokine production, blockade of NOD1, and/or NOD2 in addition to TLR4 blockade may be required to achieve therapeutic benefit. On the other hand, synergistic combinations of relatively small doses of NOD and TLR agonists administered before infection could be used to boost innate resistance against bacterial pathogens.

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“…The preventive approach would require identification of patients at increased risk of sepsis. A number of sepsis risk factors have been pinpointed (reviewed, e.g., by Fathi et al .…”

Section: Potential Clinical Relevance Of Nod‐tlr Synergymentioning

confidence: 99%

Section: Prevention Of Infectious Diseasesmentioning

confidence: 99%

Synergistic interactions between NOD receptors and TLRs: Mechanisms and clinical implications

Pashenkov

Murugina

Будихина

et al. 2018

Journal of Leukocyte Biology

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“…We also performed subgroup analyses to further investigate whether the primary outcome was different among subgroups. According to the previous studies [ 19 – 21 ] that revealed the risk factors of mortality in sepsis patients and reported the mortality rates might be different among these subgroups, we included the following subgroups: age (< 60 years; ≥ 60 years), BMI (≥ 28 kg/m 2 ; < 28 kg/m 2 ) and gender.…”

Section: Methodsmentioning

confidence: 99%

The effect of dobutamine in sepsis: a propensity score matched analysis

et al. 2021

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Background The use of dobutamine in patients with sepsis is questionable currently. As the benefit of dobutamine in septic patients is unclear, we aimed to evaluate whether the use of dobutamine was associated with decreased hospital mortality in sepsis patients. Methods Based on the analysis of MIMIC III public database, we performed a big-data, real world study. According to the use of dobutamine or not, patients were categorized as the dobutamine group or non dobutamine group.We used propensity score matched (PSM) analysis to adjust for confoundings. The primary outcome was hospital mortality. Results In the present study, after screening 38,605 patients, 2826 patients with sepsis were included. 121 patients were in dobutamine group and 2165 patients were in non dobutamine group. Compared with patients in non-dobutamine group, patients in dobutamine group had a lower MAP, higher HR, higher RR, higher severity of illness scores. 72 of 121 patients (59.5%) in the dobutamine group and 754 of 2165 patients (34.8%) in the non-dobutamine group died in the hospital, which resulted in a significant between-group difference (OR 1.56, 95% CI 1.01–2.40; P = 0.000). For the secondary outcomes, patients in dobutamine group received more MV use, more renal replacement therapy use, had longer ICU stay durations and more cardiac arrhythmias than those in non-dobutamine group. After adjusting for confoundings between groups by PSM analysis, hospital mortality was consistently higher in dobutamine group than that in non-dobutamine group (60.2% vs. 49.4%, OR 1.55, 95% CI 1.01–2.37; P = 0.044). Conclusions Among patients with sepsis, our study showed that the use of dobutamine was not associated with decreased hospital mortality. Further large scale, randomized controlled studies are warrented to confirm our findings.

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“…Studies have shown that state of consciousness and vital signs are associated with imbalance in host responses in patients with sepsis, and these variables have commonly guided the treatment of patients with sepsis. 12 Thus, we hypothesised that simple physiological indicators which reflect host response during the early stages of sepsis can provide important information for evaluating the prognosis of patients. We aimed at constructing and validating a novel and instrumental independent Simple Sepsis Early Prognostic Score (SSEPS) to predict clinical adverse outcomes in patients with sepsis during ED admission or even prehospital.…”

Section: Open Accessmentioning

confidence: 99%

Development and internal validation of a simple prognostic score for early sepsis risk stratification in the emergency department

Liu

Cheng

et al. 2021

BMJ Open

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ObjectivesNo validated, simple, powerful and continuously monitorable risk prediction tools are available for patients with sepsis during the early phases in the emergency department (ED). We sought to derive a novel Simple Sepsis Early Prognostic Score (SSEPS) composed of physiological indicators that do not depend on laboratory tests and that can be used by emergency clinicians in predicting outcomes in patients with sepsis.DesignRetrospective cohort analysis of a collected data source.ParticipantsPatients with sepsis admitted to the ED of the West China Hospital of Sichuan University between July 2015 and June 2016 were included. We excluded patients who were pregnant, those with cardiac or respiratory arrest, and those using vasoactive drugs before admission to the ED.Primary outcome measures28-day all-cause mortality.ResultsThe SSEPS consisted of age, heart rate, respiratory rate and altered consciousness. Patients in the development cohort with higher SSEPS had a significantly higher mortality (first tertile vs second tertile vs third tertile: 12.5% vs 28.6% vs 53.5%, p<0.001). The area under the receiver operating characteristic curve for SSEPS was 0.762 (95% CI 0.686 to 0.838), which was similar to Sequential Organ Failure Assessment (SOFA) (area under the curve: 0.745, 95% CI 0.692 to 0.798) and Acute Physiology and Chronic Health Evaluation (APACHE II) (area under the curve: 0.750, 95% CI 0.681 to 0.819). Moreover, the decision curve analysis showed that the net benefit of SSEPS was higher than SOFA and APACHE II at any probability threshold.ConclusionThe SSEPS is simple and useful for clinicians in stratifying high-risk patients with sepsis at the early phase of ED admission.

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A systematic review on risk factors associated with sepsis in patients admitted to intensive care units

Cited by 37 publications

References 54 publications

Synergistic interactions between NOD receptors and TLRs: Mechanisms and clinical implications

Synergistic interactions between NOD receptors and TLRs: Mechanisms and clinical implications

The effect of dobutamine in sepsis: a propensity score matched analysis

Development and internal validation of a simple prognostic score for early sepsis risk stratification in the emergency department

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