The effect of conscious disorder on the 30-day mortality of sepsis

Abstract Background Conscious impairment is related to worse prognosis in patients with sepsis. we aimed to evaluate the impact of conscious disorder on the 30-day mortality of patients with sepsis and identify the remediable risk factors for it. Methods Data were retrospectively retrieved from a prospective intensive care database. Conscious disorder was assessed by the Glasgow Coma Score (GCS). The impact of conscious dysfunction on the 30-day mortality of sepsis and its potentially modifiable risk factors were evaluated using Cox proportional hazard regression and logistic regression, respectively. Results A total of 4446 patients with sepsis were included in the study and conscious disorder (GCS < 15) was observed in 2126 (47.8%) patients. The results of Cox regression and Kaplan-Meier analysis demonstrated that GCS ≤ 12 contributed to the increased 30-day mortality of patients with sepsis and was an independent risk factor for it. Considering the clinical risks and benefits, the results of logistic regression showed that hypertension (systolic pressure ≥ 140 mmHg), hypernatremia (serum sodium ≥ 145 K/uL), the utility of cephalosporin and urinary infection are the potentially remediable risk factors for patients with sepsis characterized by GCS ≤ 12. Conclusion Moderate impairment of consciousness (GCS 9–12) and coma (GCS 3–8) were independently related to the 30-day mortality of sepsis. Potentially remediable risk factors for patients with sepsis characterized by GCS ≤ 12 at ICU admission were hypertension, hypernatremia, cephalosporin adoption and urinary infection. Further studies are needed to investigate the causal relationship between medical interventions towards these risk factors and the incidence of moderate impairment of consciousness and coma in patients with sepsis.