Aggregate evaluable organ dysfunction predicts in-hospital mortality from sepsis in Uganda

Area of Science:

• Critical Care Medicine
• Infectious Diseases
• Epidemiology

Background:

• Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
• In-hospital mortality rates for sepsis vary significantly, particularly in resource-constrained settings.
• Accurate risk stratification is crucial for managing sepsis patients effectively.

Purpose of the Study:

• To evaluate the association between sepsis severity and in-hospital mortality.
• To identify predictors of mortality in non-surgical sepsis patients in Uganda.
• To assess the utility of organ dysfunction in risk stratification for critically ill patients.

Main Methods:

• Retrospective analysis of 150 non-surgical sepsis patients at a Ugandan regional referral hospital.
• Evaluation of in-hospital mortality rates across different sepsis severity categories (sepsis, severe sepsis, septic shock).
• Multivariate analysis to determine independent predictors of mortality, including organ dysfunction.

Main Results:

• In-hospital mortality rates were 9.6% for sepsis, 33.8% for severe sepsis, and 59.3% for septic shock.
• Severe sepsis (AHR=2.9), septic shock (AHR=5.7), and ≥3 organ dysfunctions (AHR=2.9) were significant predictors of in-hospital mortality.
• Aggregate organ dysfunction significantly improved the multivariate mortality prediction model.

Conclusions:

• Sepsis severity is a strong predictor of in-hospital mortality in this Ugandan cohort.
• Easily measurable predictors, such as organ dysfunction, can effectively risk stratify critically ill patients in resource-limited settings.
• These findings support the implementation of accessible risk stratification tools in low-resource environments.