Prognostic determinants of mortality and clinical outcomes in sepsis: a retrospective cohort study

To identify key prognostic determinants in sepsis patients by evaluating clinical, laboratory, and therapeutic factors associated with 30-day mortality, organ failure, and hospitalization duration.

This retrospective cohort study was conducted on 196 ICU-admitted sepsis patients meeting the Sepsis-3 criteria from June 2019 to May 2024. Baseline characteristics, organ dysfunction scores (qSOFA, MODS), laboratory markers (lactate, bilirubin, platelet count), and cardiac function parameters (ejection fraction, BNP, troponin) were analyzed. Primary outcomes included 30-day all-cause mortality, incidence of organ failure (defined as new-onset dysfunction of ≥ 2 organ systems lasting ≥ 48 h), ICU length of stay, and total hospital length of stay.

Elevated lactate levels (OR 1.320 per 1 mmol/L increase, 95% CI 1.134-1.566; p < 0.001) and reduced ejection fraction (OR 0.936 per 1% increase, 95% CI 0.893-0.977; p = 0.001) were independent predictors of 30-day mortality. Mechanical ventilation was significantly associated with prolonged ICU stay by an average of 5.950 days (95% CI 2.938-8.962; p < 0.001). Additionally, both ventilator use (β = 4.21 days, p = 0.009) and platelet count (β=-0.016 days per 10⁹/L increase, p = 0.022) were independent predictors of total hospital length of stay. However, no independent predictors of organ failure were identified in multivariable analysis.

Lactate and ejection fraction are critical prognostic markers for 30-day mortality in sepsis, while mechanical ventilation and platelet count significantly influence hospitalization duration.