Factors relating to mortality in septic patients in Vietnamese intensive care units from a subgroup analysis of MOSAICS II study

• Main Authors: Son Ngoc Do, Chinh Quoc Luong, Dung Thi Pham, My Ha Nguyen, Nga Thi Nguyen, Dai Quang Huynh, Quoc Trong Ai Hoang, Co Xuan Dao, Trung Minh Le, Ha Nhat Bui, Hung Tan Nguyen, Hai Bui Hoang, Thuy Thi Phuong Le, Lien Thi Bao Nguyen, Phuoc Thien Duong, Tuan Dang Nguyen, Yen Hai Vu, Giang Thi Tra Pham, Tam Van Bui, Thao Thi Ngoc Pham, Hanh Trong Hoang, Cuong Van Bui, Nguyen Minh Nguyen, Giang Thi Huong Bui, Thang Dinh Vu, Nhan Duc Le, Trang Huyen Tran, Thang Quang Nguyen, Vuong Hung Le, Chi Van Nguyen, Bryan Francis McNally, Jason Phua, Anh Dat Nguyen
• Format: Article
• Language: English
• Published: Nature Publishing Group 2021-09-01
• Series: Scientific Reports
• Online Access: https://doi.org/10.1038/s41598-021-98165-8

Abstract Sepsis is the most common cause of in-hospital deaths, especially from low-income and lower-middle-income countries (LMICs). This study aimed to investigate the mortality rate and associated factors from sepsis in intensive care units (ICUs) in an LMIC. We did a multicenter cross-sectional study of septic patients presenting to 15 adult ICUs throughout Vietnam on the 4 days representing the different seasons of 2019. Of 252 patients, 40.1% died in hospital and 33.3% died in ICU. ICUs with accredited training programs (odds ratio, OR: 0.309; 95% confidence interval, CI 0.122–0.783) and completion of the 3-h sepsis bundle (OR: 0.294; 95% CI 0.083–1.048) were associated with decreased hospital mortality. ICUs with intensivist-to-patient ratio of 1:6 to 8 (OR: 4.533; 95% CI 1.621–12.677), mechanical ventilation (OR: 3.890; 95% CI 1.445–10.474) and renal replacement therapy (OR: 2.816; 95% CI 1.318–6.016) were associated with increased ICU mortality, in contrast to non-surgical source control (OR: 0.292; 95% CI 0.126–0.678) which was associated with decreased ICU mortality. Improvements are needed in the management of sepsis in Vietnam such as increasing resources in critical care settings, making accredited training programs more available, improving compliance with sepsis bundles of care, and treating underlying illness and shock optimally in septic patients.