Prognostic factors associated with mortality in septic shock: a systematic review and meta-analysis
Authors' conclusion
This systematic review and meta-analysis identified prognostic factors associated with early mortality in septic shock.
Study context
- Population
- Adults with septic shock
- Participants
- 4,831,379 adults · 95 studies
- Outcome
- Prognostic factors associated with early mortality (in-hospital or up to 31 days), as adjusted ORs
Methodological detailsrandom effects model, generic inverse variance method, 90 (95%) observational studies and five (5%) RCTs; mean age 64 years, 58% male
- Random effects model
- Generic inverse variance method
- 90 (95%) observational studies and five (5%) RCTs; mean age 64 years, 58% male
Pooled result
As reported in the abstract
Early mortality: adjusted OR per prognostic factor
- Increasing age, adjusted OR per 1 year
- 1.02 (95% CI 1.01-1.02; I2 =64%; moderate certainty)
- Black race, adjusted OR (1.21-1.25; I2 =0%; moderate certainty)
- 1.23
- Hepatic cirrhosis, adjusted OR (1.64-2.08; I2 =0%; high certainty)
- 1.85
- Malignancy, adjusted OR (1.09-1.88; I2 =91%; high certainty)
- 1.43
- Charlson comorbidity index, adjusted OR per point (1.19-1.25; I2 =0%; high certainty)
- 1.22
- AKI, adjusted OR (1.32-2.68; I2 =86%; high certainty)
- 1.88
- APACHE II score, adjusted OR per point increase (1.08-1.12; I2 =60%; high certainty)
- 1.10
- SAPS II, adjusted OR per point increase (1.06-1.09; I2 =0%; high certainty)
- 1.08
- SOFA, adjusted OR per point increase (1.15-1.28; I2 =66%; high certainty)
- 1.21
- Invasive mechanical ventilation, adjusted OR (1.00-4.51; I2 =86%; moderate certainty)
- 2.12
- Norepinephrine use, adjusted OR (2.73-4.74; I2 =0%; high certainty)
- 3.60
- Elevated serum lactate, adjusted OR per 1 mmol/L (1.01-1.26; I2 =72%; high certainty)
- 1.13
Further pooled results
Early hospital mortality (all patients)
- Early hospital mortality, 1 606 384 patients (IQR 29.5-37.3)
- 33.2%
Original publication
Prognostic factors associated with mortality in septic shock: a systematic review and meta-analysis. Lancet Respir Med. Published 28 January 2026. doi:10.
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