Epidemiological and clinical characteristics of sepsis-associated encephalopathy in the ICU: a retrospective observational study

Background Sepsis has an annual incidence of 30 million new cases around worldwide. However, the epidemiological and clinical characteristics in patients with sepsis-associated encephalopathy (SAE) remain understudy.Methods We prospectively enrolled patients with acute critically ill from ICU during 2 years period (2014-2015). The epidemiological and clinical characteristics for critically ill adults with SAE in ICU were analyzed by related statistics.Results Of the 1349 ICU patients with acute critically ill, 748 were enrolled. Among these, the prevalence of sepsis was 48.4% (362/748), with fatality at initial 30 days was 62.4%. The prevalence of SAE accounted for 97.2% of sepsis (352/362), with fatality at initial 30 days was 65.1%. We found that the two strong clinical predictors for SAE were systemic inflammatory response syndrome (SIRS) ≥2 (OR, 3.2; 95% CI, 0.304- 0.673) and sequential (sepsis-related) organ function assessment (SOFA) score ≥6 (GCS<13)(OR, 3.0; 95% CI, 0.304-0.673); the sensitivity was 67.3% and specificity was 55.3% for SIRS≥2, while the sensitivity was 99.1% and specificity was 99.0% for SOFA score≥6. Cox logistic adjusted analysis revealed that lower mean arterial pressure (OR, 1.504; 95% CI, 1.001-1.707),higher SOFA score (OR, 1.783; 95% CI, 1.145- 1.923), and no using antibiotics treatment in initial 3 hours (OR, 0.683; 95% CI, 0.492-0.947) were the powerful predictors of the risk of death among ICU patients with SAE.Conclusion SAE is a best frequent epidemiological type of sepsis in ICU, with an high hospital fatality. No using antibiotics treatment within initial 3 hours was related to the worse survival SAE.