Abstract

Background: Sepsis remains a leading cause of hospital mortality worldwide, placing significant pressure on healthcare systems, including in Vietnam, where the mortality rate is reported at 20-50%. Therefore, investigating severe prognostic factors in patients with sepsis is crucial for improving prevention and treatment outcomes.

Methods: The study included all patients admitted to the Intensive Care Unit (ICU) at Hue Central Hospital from September 2024 to November 2024. Data were collected from medical records, patient interviews (if patients could respond), or their relatives.

Results: The mean age of the study group was 64.44 ± 15.75 years, with a male-to-female ratio of 1.56:1. Clinical characteristics: The most common comorbidities were hypertension (27.1%) and diabetes mellitus (22.6%), with 83% of patients having concurrent diseases. The most frequent infection sites were the respiratory tract (55%), gastrointestinal tract (21%), and nervous system (15%). The incidence of septic shock was 60.7%, with a mortality rate of 48.6%.
Laboratory findings: The mean leukocyte count was 14.01 ± 8.78 k/mL, total bilirubin was 23.17 ± 48.53 mmol/L, urea was 12.91 ± 10.99 mmol/L, and creatinine was 153.92 ± 148.95 mmol/L. Positive blood culture results were observed in 33.6% of patients. Severe prognostic factors included a PCT level of 7.012 ng/mL (sensitivity: 89.2%, specificity: 78.2%) and lactate level of 2.395 mmol/L (sensitivity: 93.8%, specificity: 78.6%). Additionally, a SOFA score of 7.5 and an APACHE II score of 19.5 were valuable in predicting severe outcomes in septic patients.

Conclusion: The biomarkers PCT and blood lactate levels are valuable for predicting severe outcomes in sepsis patients. Furthermore, the SOFA and APACHE II scoring systems are useful in predicting progression to septic shock and mortality in the study population.