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Potentially modifiable factors contributing to sepsis-associated encephalopathy
Romain Sonneville1,2, Etienne de Montmollin3,4, Julien Poujade5
1Department of Intensive Care Medicine and Infectious Diseases, Hôpital Bichat-Claude Bernard, 46 rue Henri Huchard, 75877, Paris Cedex, France. romain.sonneville@aphp.fr.
Intensive Care Medicine
|May 4, 2017
Summary
Identifying modifiable factors for sepsis-associated encephalopathy (SAE) is key. Acute renal failure and metabolic issues like hypoglycemia and hyperglycemia are linked to SAE, impacting patient outcomes and mortality.
Area of Science:
- Critical Care Medicine
- Neurology
- Infectious Diseases
Background:
- Sepsis-associated encephalopathy (SAE) affects over half of sepsis patients.
- Understanding modifiable risk factors for SAE is crucial for improving patient care and outcomes.
Purpose of the Study:
- To identify modifiable risk factors associated with sepsis-associated encephalopathy (SAE).
- To investigate the impact of SAE on mortality in intensive care unit (ICU) patients.
Main Methods:
- Retrospective analysis of a prospective multicenter database including 2513 sepsis patients.
- SAE defined by Glasgow Coma Scale (GCS) score <15 or delirium.
- Multivariate logistic regression and Cox proportional hazard modeling were used.
Main Results:
- Acute renal failure, hypoglycemia, hyperglycemia, hypercapnia, and hypernatremia were independently associated with SAE.
- S. aureus infection was also linked to increased SAE risk.
- SAE was associated with higher mortality, increased ICU resource utilization, and longer hospital stays.
- Mild alterations in mental status (GCS 13-14) independently predicted mortality.
Conclusions:
- Acute renal failure and metabolic disturbances are potential modifiable contributors to SAE.
- The prognostic significance of even mild alterations in mental status in sepsis patients is confirmed.
- Further research is needed to establish a causal relationship.
