Early systemic insults following severe sepsis-associated encephalopathy of critically ill patients: association with mortality and awakening—an analysis of the OUTCOMEREA database
Authors' conclusion
In patients with severe SAE, the persistence of systemic insults within the first three days of ICU admission is associated with increased mortality and decreased chances of awakening.
Study context
- Population
- Intensive care unit (ICU) patients ≥48 h with severe sepsis-associated encephalopathy (SAE) (Glasgow Coma Scale (GCS) ≤ 13 and severe sepsis or septic shock) requiring invasive ventilation, without primary brain injury, French OUTCOMEREA database
- Participants
- 995 patients
- Exposure
- Persistent vs corrected early systemic insults at day 3
- Outcome
- Mortality and awakening (recovery of GCS > 13)
- Follow-up
- Day 28
Main finding
As reported in the abstract
Day-28 mortality by absence of correction of systemic insults at day 3
Adjusted hazard ratio (95% CI)
Blood pressure
1.77(1.34–2.34)
Oxygenation
1.78(1.20–2.63)
Temperature
1.46(1.12–1.91)
Glycemia
1.41(1.10–1.80)
Observational data: associations, not effects.
Further findings
Prevalence of early systemic insults persisting through day 3
- ≥1 early systemic insult persisting through day 3
- 883 (89%)
Early systemic insults within first 48 h, survivors vs non-survivors
- Survivors had significantly fewer early insults (hypoglycemia, hypotension, hypothermia, anemia)
Original publication
Early systemic insults following severe sepsis-associated encephalopathy of critically ill patients: association with mortality and awakening—an analysis of the OUTCOMEREA database. J Intensive Care. Published 14 January 2025. doi:10.
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