Septic shock without documented infection: an uncommon entity with a high mortality

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Emergency Medicine

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• Septic shock is a subset of sepsis with circulatory, cellular, and metabolic abnormalities associated with higher mortality.
• Identifying the source of infection is a critical step in managing sepsis and septic shock.

Purpose of the Study:

• To compare the outcomes of patients with septic shock and a clinically identified infection source versus those with apparent sepsis but no identified source.
• To investigate the impact of an unidentified infection source on intensive care unit (ICU) mortality in septic shock patients.

Main Methods:

• Retrospective analysis of patient data from a 31-bed intensive care unit (ICU).
• Inclusion criteria: patients treated for septic shock over a 3-year period.
• Data analysis focused on comparing mortality rates between patients with and without an identified source of infection.

Main Results:

• A total of 227 patients with septic shock were analyzed.
• Eighty-seven percent of patients had a clinically identified source of infection.
• ICU mortality was significantly higher in septic shock patients without an identified infection source (86%) compared to those with an identified source (66%, p < 0.05).

Conclusions:

• A subset of patients with septic shock lack a clinically identified infection source.
• These patients experience a higher mortality rate, underscoring the importance of source identification.
• Further research may be warranted to explore reasons for higher mortality in this subgroup.