Tuesday September 23, 2008
Mortality in Acute Lung Injury due to Pulmonary vs. Nonpulmonary Sepsis

Janothan Sevransky from John Hopkins studied 288 patients with sepsis induced ALI and prospectively classified as having pulmonary vs. non pulmonary sources of sepsis.

Result: Unadjusted analysis revealed, lower in hospital mortality for pulmonary sepsis vs. nonpulmonary sepsis (42% vs. 66%, p less than 0.0001).

Adjusted analysis several factors predicted the mortality:

• Age: OR 1.03
• Charlson co morbidity index: OR 1.15
• ICU length of stay prior to ALI diagnosis: OR 1.19
• APACHE II score: OR 1.07
• Lung injury score: OR 1.64
• SOFA score: OR 1.15
• Cumulative fluid balance in first 7 days after ALI diagnosis: OR 1.06

A pulmonary vs. non pulmonary source of sepsis was not independently associated with mortality: OR 0.72

Conclusion: Although lower mortality was observed for ALI patients with a pulmonary vs. non pulmonary source of sepsis, this finding was due to lower severity of illness in those with pulmonary sepsis.



Reference: click to get abstract

Sevransky JE, Martin GS, Mendez-Tellez P, Shanholtz C, Brower R, Pronovost PJ, Needham DM. pulmonary vs nonpulmonary sepsis and mortality in acute lung injury. Chest 2008; 134: 534-538