Markers of mortality in patients with sepsis

Introduction: Every other day, number of the patients with sepsis/severe sepsis is increasing and sepsis is gaining importance among the other causes of death. Patients with sepsis/severe sepsis constitute the half of the patients in intensive care units. In this syndrome which?s prevalence and mortality is increasing, absence of follow-up parameters predicting mortality is a serious problem in the follow-up of the patients. The aim of the study is to evaluate the relationship between comorbidities, APACHE (Acute Physiology and Chronic Health Evaluation) scores, SOFA (Sequential Organ Failure Score) scores, some biochemical following parameters and mortality and to share data of our intensive care unit.Material and Method: The patients diagnosed as sepsis between the years of 2003-2009? in The Intensive Care Unit of Internal Medicine Department were retrospectively evaluated. The relationship between the epidemiological parameters, APACHE-SOFA scores, biochemical parameters at the time of the diagnosis and 3 days after the diagnosis and predicting survival were analyzed.Results: Among 420 patients with sepsis, data of 376 patients were collected sufficeintly, patients were divided into two subgroups as died and alive. Among 376 patients with sepsis, 253 patients (67%) were dead. Malignancy (Ca) (p=0.013) was significantly higher in died patients group while diabetes mellitus (DM), chronic renal failure (CRF) and chronic obstructive pulmonary disease (COPD) were not significantly different between the groups. APACHE and SOFA scores were significantly higher among died patient group (respectively p=<0.001-<0.001). Platelet count at the time of the diagnosis was significantly lower in died patients group (p=<0.001), leukocyte and lymphocyte count and level of C reactive protein (CRP) was not significantly different between the study groups. After a following period of three days, platelet count was significantly decreased among died patients. The change in the other biochemical parameters was not significantly different between the study groups.Conclusion: APACHE and SOFA scores are still the most reliable prognostic factors in intensive care units. CRP and leukocyte count are important in the follow-up of the patients but are insufficient to predict prognosis. At the time of the diagnosis and during the follow-up, low platelet count is associated with poor prognosis.