Prevalence, mortality rate, and factors associated with mortality in patients with sepsis in Vietnam

The burden of sepsis in Vietnam remains largely undocumented. This study aims to estimate the prevalence and mortality rate of sepsis and to identify mortality-associated factors among patients with sepsis in a Vietnamese hospital.

A prospective observational study was conducted to describe the clinical features, laboratory characteristics, and mortality rate of patients with sepsis. All patients admitted to intensive care units with culture-confirmed sepsis from October 2018 to December 2020 were included. Logistic regression and receiver operating characteristic analyses were conducted to identify mortality predictors.

Of the 3890 enrolled patients, 2.7% (105 patients) had culture-confirmed sepsis, with 64% (67/105) classified as sepsis and 36% (38/105) as septic shock. The overall mortality rate was 52% (55 out of 105), with mortality rates of 42% (28 out of 67) for sepsis and 71% (27 out of 38) for septic shock. Escherichia coli (38%) was the most frequently isolated pathogen. Although resistance to carbapenems and third-generation cephalosporins was high, it was not associated with an increased risk of mortality. Logistic regression analysis identified neurologic dysfunction, comorbidities, blood lactate levels, and the number of acute organ dysfunctions as independent predictors of mortality in the overall cohort (area under the curve = 0.77). Among patients infected with E. coli or Klebsiella pneumoniae, hypertension, mechanical ventilation, and renal dysfunction were independently associated with mortality (area under the curve = 0.8).

Patients with sepsis in Vietnam exhibited a high mortality rate, with E. coli identified as the most common pathogen. Neurologic dysfunction was an independent predictor of mortality, whereas antibiotic resistance was not associated with higher mortality. The identified risk factors may help guide early clinical interventions to improve patient outcomes.