Determinants of survival time in patients with sepsis: A cross-sectional study

Background/Aim: Sepsis remains a major cause of in-hospital mortality and early outcomes may depend on comorbidity, infection characteristics and treatment. The aim was to examine demographic, clinical and microbiological factors associated with survival time (≤ 7 versus > 7 days) in patients with sepsis. Methods: This retrospective cross-sectional study used the records of adults diagnosed with sepsis at a tertiary referral hospital. Demographic variables, Charlson Comorbidity Index (CCI), infection source, microbiological findings, antimicrobial resistance and antibiotic appropriateness were recorded. The outcome was categorised as survival time of ≤ 7 or > 7 days. Variables significant in bivariate analyses were entered into stepwise multivariable logistic regression. Results: Among 143 patients, 62 (43.4 %) were in the ≤ 7-day group and 81 (56.6 %) in the > 7-day group. In the final model, CCI ≥ 5 (odds ratio [OR] 3.02, 95 % confidence interval [CI] 1.38-6.65; p = 0.006) and antimicrobial resistance (OR 8.00, 95 % CI 3.19-19.45; p < 0.001) were associated with greater odds of the ≤ 7-day outcome. Methicillin-resistant Staphylococcus aureus (MRSA), extended-spectrum beta-lactamase (ESBL) production and ceftriaxone resistance were not statistically significant in the final model. Appropriate antibiotic therapy was associated with lower odds in bivariate analysis but was not retained in the final model. Conclusion: Higher comorbidity burden and antimicrobial resistance were associated with the ≤ 7-day outcome in this cohort. Although appropriate antibiotic therapy was associated with the outcome in bivariate analysis, an independent association was not demonstrated in the final model. These findings support further evaluation of comorbidity and resistance profiles in early risk assessment.