Factors Associated with Mortality in Septic Shock Patients at Chaiyaphum Hospital

Abstract

            Septic shock is associated with high mortality, and its burden remains substantial in Thailand. This cross-sectional analytical study using secondary data aimed to identify factors associated with in-hospital mortality among adult septic shock patients. A total of 134 patients aged 18 years or older, admitted to Chaiyaphum Hospital between March and December 2023, were included. Septic shock was defined as vasopressor requirement to maintain mean arterial pressure of at least 65 mmHg with serum lactate above 2 mmol/L despite fluid resuscitation. Data were extracted from medical records and the hospital database and analyzed using multivariable logistic regression.

            Of the 134 patients, 80 (59.7%) died in hospital and 54 survived. No significant differences in age, sex, or comorbidities were observed, although non-survivors had higher SOFA scores (10.0 vs. 8.0, p<0.001), higher lactate, and lower albumin. Survivors more often received at least 30 mL/kg of fluid within 3 hours (68.5% vs. 42.5%, p=0.005) and were admitted to the ICU within 4 hours (96.4% vs. 76.4%, p=0.028). After adjustment, only two factors remained independently associated with mortality: ICU admission within 4 hours (adjusted odds ratio 0.10; 95% CI 0.01, 0.89) and serum albumin below 2.45 g/dL (adjusted odds ratio 4.75; 95% CI 1.60, 14.06). The model showed good fit and discrimination.

            Timely ICU admission and hypoalbuminemia were independent predictors of in-hospital mortality among septic shock patients at this provincial hospital. These findings support rapid critical-care referral and early albumin measurement for risk stratification, with prospective multicenter studies needed to confirm generalizability.