Factors Associated with Clinical Symptom Deterioration in Sepsis Patients within 72 Hours Following Hospitalization
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Abstract
Abstract
This retrospective cohort study aimed to ascertain the frequency and contributing factors associated with the deterioration of clinical conditions in sepsis patients within 72 hours of their hospitalization. The study encompassed a cohort of 270 individuals diagnosed with sepsis at Lampang Hospital's Accident and Emergency Department and Inpatient Department. Data were extracted from medical records spanning September 2020 to August 2021. Research instruments included a patient-specific data record form, a health assessment record form, a patient care form, and a clinical deterioration assessment form. Content validity assessment were conducted by three experts, yielding a content validity index of 0.96. Analytical methods encompassed descriptive statistics and binary logistic regression.
The findings revealed that within the first 6 to 72 hours post-treatment, 53.70% of sepsis patients exhibited clinical deterioration. Worsening clinical symptoms primarily manifested within the circulatory, respiratory, nervous, and cerebral systems. The most substantial impact on symptom exacerbation was observed among patients admitted to the intensive care unit, resulting in a 2.69-fold increase in symptom deterioration (95% CI 1.16-5.05). Subsequently, the influence of underlying medical conditions and age were noted, with individuals having a single underlying condition experiencing a 2.42-fold symptom worsening (95% CI 1.16-5.05), those with multiple underlying conditions facing a 2.75-fold symptom aggravation (95% CI 1.30-5.80), individuals aged 65-79 undergoing a 2.19-fold symptom deterioration (95% CI 1.01-4.76), and those aged 79 years and older encountering a 2.23-fold symptom deterioration (95% CI 1.04-4.78).
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