Predictors of Lethal Outcomes in Patients with Refractory Septic Shock
https://doi.org/10.21292/2078-5658-2021-18-3-30-35
Abstract
Early prediction of disease severity helps clinicians prevent adverse events and/or minimize losses in the event of a life-threatening complication. This provision fully applies to refractory septic shock, in which norepinephrine administration at a dose exceeding 0.5 μg/kg-1/min-1 is needed to maintain mean arterial pressure.
The objective: to determine predictors of lethal outcomes in patients with refractory septic shock.
Subjects and methods. A retrospective study included 79 patients with refractory septic shock aged from 42 to 74 years (59.7 ± 7.8), with severity of the condition as per SOFA varying from 8 to 16 scores. The predictive value of indicators was assessed using univariate and multivariate analyses.
Results. In multivariate analysis, the only significant predictor of an unfavorable outcome was the SOFA score (adj. OR: 1.626 [95% CI: 1.313; 2.014], p < 0.001). Other putative indicators (age, oxygenation index, lactate and procalcitonin concentrations, and norepinephrine dose) had no predictive value.
Conclusion: The SOFA score is an independent predictor of lethality in adult patients with refractory septic shock (аdj. OR: 1.26 [95% CI: 1.313; 2.014], p < 0.001). According to the results of the ROC analysis, along with SOFA, norepinephrine dose was also a significant predictor (AUC 0.989 [95% CI 0.934; 1.000], p < 0.001).
About the Authors
А. А. Kochkin
M. F. Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation
Russian Federation
Aleksandr A. Kochkin, Researcher of Intensive Care Department
61/2, Schepkina St., Moscow, 129110
Phone/Fax: +7 (495) 929-58-04
M. Ya. Yadgarov
V. A. Negovsky Reanimatology Research Institute, Federal Scientific and Clinical Center for Intensive Care and Rehabilitation
Russian Federation
Russian Federation
Mikhail Ya. Yadgarov, Physician Cyberneticist, Junior Researcher of Clinical Trial Laboratory
Build. 25, 2, Petrovka St., Moscow, 107031
L. B. Berikashvili
V. A. Negovsky Reanimatology Research Institute, Federal Scientific and Clinical Center for Intensive Care and Rehabilitation
Russian Federation
Russian Federation
Levan B. Berikashvili, Researcher of Clinical Trial Laboratory
Build. 25, 2, Petrovka St., Moscow, 107031
S. N. Perekhodov
A. I. Yevdokimov Moscow State University of Medicine and Dentistry
Russian Federation
Russian Federation
Sergey N. Perekhodov, Doctor of Medical Sciences, Professor of Hospital Surgery Department General Medicine Faculty
Build. 20, 1, Delegatskaya St., Moscow, 127473
V. V. Likhvantsev
M. F. Vladimirsky Moscow Regional Research Clinical Institute; V. A. Negovsky Reanimatology Research Institute, Federal Scientific and Clinical Center for Intensive Care and Rehabilitation
Russian Federation
Russian Federation
Valeriy V. Likhvantsev, Doctor of Medical Sciences, Professor, Deputy Head for Research
Build. 25, 2, Petrovka St., Moscow, 107031
Phone: +7 (495) 694-65-05
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Review
For citations:
Kochkin А.А., Yadgarov M.Ya., Berikashvili L.B., Perekhodov S.N., Likhvantsev V.V. Predictors of Lethal Outcomes in Patients with Refractory Septic Shock. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2021;18(3):30-35. (In Russ.) https://doi.org/10.21292/2078-5658-2021-18-3-30-35
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