Post-Op, Sepsis More Common Than MI, Pulmonary Embolism

Age over 60, emergency surgery, and comorbid conditions are risk factors for sepsis
By Lindsey Marcellin
HealthDay Reporter

TUESDAY, July 20 (HealthDay News) -- The incidence of post-surgical sepsis is higher than the incidence of post-surgical myocardial infarction or pulmonary embolism, and risk factors for sepsis include older age, need for emergency surgery, and comorbidities, according to research published in the July issue of the Archives of Surgery.

Laura J. Moore, M.D., of the Weill Cornell Medical College in Houston, and colleagues conducted a retrospective study of general-surgery patients from the 2005 to 2007 National Surgical Quality Improvement Program data set. Measured outcomes were risk factors, incidence, and mortality for sepsis and septic shock, which were compared to the same factors in pulmonary embolism and myocardial infarction.

The researchers found that sepsis or septic shock occurred in 2.3 and 1.6 percent, respectively, of general-surgery patients, compared to pulmonary embolism and myocardial infarction, which occurred in 0.3 and 0.2 percent, respectively. The 30-day mortality rates were 5.4 percent for sepsis, 33.7 percent for septic shock, 9.1 percent for pulmonary embolism, and 32.0 percent for myocardial infarction. The need for emergency surgery was associated with an increased risk of sepsis and septic shock, and the septic shock group had a higher percentage of individuals older than 60; the presence of a comorbidity significantly increased the risk of sepsis/septic shock (odds ratio, 5.8) and the 30-day mortality rate (odds ratio, 21.8).

"By identifying three major risk factors for the development of and death from sepsis and septic shock in general-surgery patients, we can heighten our awareness for sepsis and septic shock in these at-risk populations. The implementation of mandatory sepsis screening for these high-risk populations has resulted in decreased sepsis-related mortality within our institution. Further evaluation of the role of sepsis screening programs in other settings is critical and could significantly reduce sepsis-related mortality in general-surgery patients," the authors write.

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