Predictors of Septic Shock Mortality at a Tertiary Hospital in Ethiopia: A Prospective Observational Study

Abstract

Background: Septic shock causes significant mortality, ranging from 30% to 50%, with a slight difference in developing and developed countries. There is insufficient evidence in Ethiopia regarding septic shock mortality. Therefore, we aimed to determine the in-hospital mortality rate and its predictors among septic shock patients admitted to a tertiary hospital in Ethiopia. Methods: A hospital-based prospective observational study was conducted among septic shock patients admitted to Yekatit 12 Hospital Medical College (Y12HMC) from January to September 2023. All patients with septic shock who fulfilled the inclusion criteria were included and followed until discharge or death. We collected sociodemographic characteristics, clinical and laboratory parameters, microbiologic findings, and treatment-related data from eligible patients using a standardized data extraction format. Data entry and analysis were done using Statistical Package for Social Sciences (SPSS) version 25. The multivariable analysis using the Cox regression model was used to determine the predictors of in-hospital mortality, with P < 0.05 representing statistical significance. Results: A total of 144 septic shock patients were included in the study. The mean age was 46 ± 19 years, with a range of 15 to 95 years. The overall in-hospital mortality of septic shock patients was 66.7%. The multivariable Cox regression analysis revealed that low Glasgow coma scale (GCS) [adjusted hazard ratio: 2.23, 95% CI: 1.35-3.69, P = 0.01] and low peripheral oxygen saturation (SpO2) [adjusted hazard ratio: 8.74, 95% CI: 1.18-14.84, P = 0.03] at diagnosis were independently associated with a higher risk of in-hospital mortality. Conclusion: Septic shock mortality was found significantly higher in our study. Septic shock patients with low GCS and SpO2 at the time of diagnosis require a vigilant care. Early identification of high-risk patients, applying appropriate and compressive management could reduce the mortality.