Impact of encephalopathy on mortality in the sepsis syndrome

C. L. Sprung, P. N. Peduzzi, C. H. Shatney, Roland Schein, M. F. Wilson, J. N. Sheagren, L. B. Hinshaw, K. Hostetter, K. Wilson, P. Therass, C. LaRosa, R. Eng, C. Kitchell, N. Brennon, P. Dobrin, P. Gully, E. J. Young, C. Stewart, R. Read

Research output: Contribution to journalArticle

289 Citations (Scopus)

Abstract

Sepsis, an important cause of hospital mortality, continued to be a diagnostic and therapeutic challenge. To define more clearly the impact of encephalopathy on the course of sepsis, the various clinical signs of sepsis, blood culture results, and mortality rates were examined in relation to mental status in septic patients. Patients were classified as having an acutely altered mental status due to sepsis (AAMS), preexisting altered mental status (PAMS), or normal mental status (NMS). Twenty-three (307/1333) percent of the study patients had an acutely altered sensorium secondary to sepsis. Patients with AAMS had a higher mortality (49%) than patients with PAMS (41%) or patients with NMS (26%) (p < .000001). Multivariate analysis disclosed that altered mental status, hypothermia, hypotension, thrombocytopenia, and the absence of shaking chills were independent predictors of increased mortality in the sepsis syndrome. Patients with Gram-negative bacteremia (28%) were as likely to have AAMS as patients with Gram-positive bacteremia (25%) or patients with negative blood cultures (23%). In summary, alterations in mental status are common in septic patients, and are associated with significantly higher mortality.

Original languageEnglish
Pages (from-to)801-806
Number of pages6
JournalCritical Care Medicine
Volume18
Issue number8
StatePublished - Jan 1 1990
Externally publishedYes

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Systemic Inflammatory Response Syndrome
Brain Diseases
Mortality
Sepsis
Bacteremia
Chills
Hospital Mortality
Hypothermia
Thrombocytopenia
Hypotension
Multivariate Analysis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Sprung, C. L., Peduzzi, P. N., Shatney, C. H., Schein, R., Wilson, M. F., Sheagren, J. N., ... Read, R. (1990). Impact of encephalopathy on mortality in the sepsis syndrome. Critical Care Medicine, 18(8), 801-806.

Impact of encephalopathy on mortality in the sepsis syndrome. / Sprung, C. L.; Peduzzi, P. N.; Shatney, C. H.; Schein, Roland; Wilson, M. F.; Sheagren, J. N.; Hinshaw, L. B.; Hostetter, K.; Wilson, K.; Therass, P.; LaRosa, C.; Eng, R.; Kitchell, C.; Brennon, N.; Dobrin, P.; Gully, P.; Young, E. J.; Stewart, C.; Read, R.

In: Critical Care Medicine, Vol. 18, No. 8, 01.01.1990, p. 801-806.

Research output: Contribution to journalArticle

Sprung, CL, Peduzzi, PN, Shatney, CH, Schein, R, Wilson, MF, Sheagren, JN, Hinshaw, LB, Hostetter, K, Wilson, K, Therass, P, LaRosa, C, Eng, R, Kitchell, C, Brennon, N, Dobrin, P, Gully, P, Young, EJ, Stewart, C & Read, R 1990, 'Impact of encephalopathy on mortality in the sepsis syndrome', Critical Care Medicine, vol. 18, no. 8, pp. 801-806.
Sprung CL, Peduzzi PN, Shatney CH, Schein R, Wilson MF, Sheagren JN et al. Impact of encephalopathy on mortality in the sepsis syndrome. Critical Care Medicine. 1990 Jan 1;18(8):801-806.
Sprung, C. L. ; Peduzzi, P. N. ; Shatney, C. H. ; Schein, Roland ; Wilson, M. F. ; Sheagren, J. N. ; Hinshaw, L. B. ; Hostetter, K. ; Wilson, K. ; Therass, P. ; LaRosa, C. ; Eng, R. ; Kitchell, C. ; Brennon, N. ; Dobrin, P. ; Gully, P. ; Young, E. J. ; Stewart, C. ; Read, R. / Impact of encephalopathy on mortality in the sepsis syndrome. In: Critical Care Medicine. 1990 ; Vol. 18, No. 8. pp. 801-806.
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AU - Shatney, C. H.

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AU - Wilson, M. F.

AU - Sheagren, J. N.

AU - Hinshaw, L. B.

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AU - LaRosa, C.

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AU - Brennon, N.

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AU - Gully, P.

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AU - Stewart, C.

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N2 - Sepsis, an important cause of hospital mortality, continued to be a diagnostic and therapeutic challenge. To define more clearly the impact of encephalopathy on the course of sepsis, the various clinical signs of sepsis, blood culture results, and mortality rates were examined in relation to mental status in septic patients. Patients were classified as having an acutely altered mental status due to sepsis (AAMS), preexisting altered mental status (PAMS), or normal mental status (NMS). Twenty-three (307/1333) percent of the study patients had an acutely altered sensorium secondary to sepsis. Patients with AAMS had a higher mortality (49%) than patients with PAMS (41%) or patients with NMS (26%) (p < .000001). Multivariate analysis disclosed that altered mental status, hypothermia, hypotension, thrombocytopenia, and the absence of shaking chills were independent predictors of increased mortality in the sepsis syndrome. Patients with Gram-negative bacteremia (28%) were as likely to have AAMS as patients with Gram-positive bacteremia (25%) or patients with negative blood cultures (23%). In summary, alterations in mental status are common in septic patients, and are associated with significantly higher mortality.

AB - Sepsis, an important cause of hospital mortality, continued to be a diagnostic and therapeutic challenge. To define more clearly the impact of encephalopathy on the course of sepsis, the various clinical signs of sepsis, blood culture results, and mortality rates were examined in relation to mental status in septic patients. Patients were classified as having an acutely altered mental status due to sepsis (AAMS), preexisting altered mental status (PAMS), or normal mental status (NMS). Twenty-three (307/1333) percent of the study patients had an acutely altered sensorium secondary to sepsis. Patients with AAMS had a higher mortality (49%) than patients with PAMS (41%) or patients with NMS (26%) (p < .000001). Multivariate analysis disclosed that altered mental status, hypothermia, hypotension, thrombocytopenia, and the absence of shaking chills were independent predictors of increased mortality in the sepsis syndrome. Patients with Gram-negative bacteremia (28%) were as likely to have AAMS as patients with Gram-positive bacteremia (25%) or patients with negative blood cultures (23%). In summary, alterations in mental status are common in septic patients, and are associated with significantly higher mortality.

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