Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors

<i>Background and Objectives:</i> Sepsis is a leading cause of morbidity and mortality worldwide, yet data from Central and Eastern Europe remain scarce. Our study aims to address the scarcity of information regarding the characteristics and mortality rates of patients with sepsis by rep...

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Main Authors: Florentina Mușat, Dan Nicolae Păduraru, Alexandra Bolocan, Cosmin-Alexandru Palcău, Andrei-Alexandru Bunea, Daniel Ion, Octavian Andronic
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/5/864
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author Florentina Mușat
Dan Nicolae Păduraru
Alexandra Bolocan
Cosmin-Alexandru Palcău
Andrei-Alexandru Bunea
Daniel Ion
Octavian Andronic
author_facet Florentina Mușat
Dan Nicolae Păduraru
Alexandra Bolocan
Cosmin-Alexandru Palcău
Andrei-Alexandru Bunea
Daniel Ion
Octavian Andronic
author_sort Florentina Mușat
collection DOAJ
description <i>Background and Objectives:</i> Sepsis is a leading cause of morbidity and mortality worldwide, yet data from Central and Eastern Europe remain scarce. Our study aims to address the scarcity of information regarding the characteristics and mortality rates of patients with sepsis by reporting recent data from one of the largest emergency centers in Romania over an 18-year period (2007–2024). <i>Materials and Methods:</i> A retrospective analysis was conducted on 12,089 adult patients diagnosed with sepsis at the University Emergency Hospital of Bucharest. Patients were identified using International Classification of Diseases (ICD-10) codes and free-text diagnosis. Demographic and clinical data were extracted, including comorbidities, interventions, and mortality outcomes. Associations between comorbidities and in-hospital mortality were assessed using odds ratios (ORs) and 95% confidence intervals (CIs). <i>Results:</i> The study population had a mean age of 68.7 years, with a slight predominance of males (50.9%). In-hospital mortality was 53.9%, and 30-day mortality reached 85.1%. The most common comorbidities were diabetes (27.2%), chronic kidney disease (14.0%), and cancer (12.9%). Pneumonia (OR = 2.08, 95% CI: 1.89–2.28), cirrhosis (OR = 1.69, 95% CI: 1.40–2.03), and chronic obstructive pulmonary disease (OR = 1.50, 95% CI: 1.27–1.77) were strong predictors of mortality, while diabetes was associated with a slightly lower risk (OR = 0.90, 95% CI: 0.83–0.97). <i>Conclusions:</i> Sepsis-related mortality in Romania is higher than reported in Western Europe and North America, resembling trends in resource-limited settings. Targeted early recognition, antimicrobial stewardship, and improved intensive care units (ICU) resource allocation are crucial for reducing mortality. Multicenter studies and microbiological analyses are needed to further understand sepsis outcomes in this region.
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spelling doaj-art-cd4e5acff43c4432910762246f83654c2025-08-20T01:56:32ZengMDPI AGMedicina1010-660X1648-91442025-05-0161586410.3390/medicina61050864Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk FactorsFlorentina Mușat0Dan Nicolae Păduraru1Alexandra Bolocan2Cosmin-Alexandru Palcău3Andrei-Alexandru Bunea4Daniel Ion5Octavian Andronic6Carol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, RomaniaDepartment of Computer Science, National University of Science and Technology Politehnica Bucharest, 060042 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, RomaniaCarol Davila University of Medicine and Pharmacy, Faculty of Medicine, General Surgery Department, University Emergency Hospital of Bucharest, 050098 Bucharest, Romania<i>Background and Objectives:</i> Sepsis is a leading cause of morbidity and mortality worldwide, yet data from Central and Eastern Europe remain scarce. Our study aims to address the scarcity of information regarding the characteristics and mortality rates of patients with sepsis by reporting recent data from one of the largest emergency centers in Romania over an 18-year period (2007–2024). <i>Materials and Methods:</i> A retrospective analysis was conducted on 12,089 adult patients diagnosed with sepsis at the University Emergency Hospital of Bucharest. Patients were identified using International Classification of Diseases (ICD-10) codes and free-text diagnosis. Demographic and clinical data were extracted, including comorbidities, interventions, and mortality outcomes. Associations between comorbidities and in-hospital mortality were assessed using odds ratios (ORs) and 95% confidence intervals (CIs). <i>Results:</i> The study population had a mean age of 68.7 years, with a slight predominance of males (50.9%). In-hospital mortality was 53.9%, and 30-day mortality reached 85.1%. The most common comorbidities were diabetes (27.2%), chronic kidney disease (14.0%), and cancer (12.9%). Pneumonia (OR = 2.08, 95% CI: 1.89–2.28), cirrhosis (OR = 1.69, 95% CI: 1.40–2.03), and chronic obstructive pulmonary disease (OR = 1.50, 95% CI: 1.27–1.77) were strong predictors of mortality, while diabetes was associated with a slightly lower risk (OR = 0.90, 95% CI: 0.83–0.97). <i>Conclusions:</i> Sepsis-related mortality in Romania is higher than reported in Western Europe and North America, resembling trends in resource-limited settings. Targeted early recognition, antimicrobial stewardship, and improved intensive care units (ICU) resource allocation are crucial for reducing mortality. Multicenter studies and microbiological analyses are needed to further understand sepsis outcomes in this region.https://www.mdpi.com/1648-9144/61/5/864sepsisepidemiologyrisk factorscomorbiditiesmortalityoutcomes
spellingShingle Florentina Mușat
Dan Nicolae Păduraru
Alexandra Bolocan
Cosmin-Alexandru Palcău
Andrei-Alexandru Bunea
Daniel Ion
Octavian Andronic
Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
Medicina
sepsis
epidemiology
risk factors
comorbidities
mortality
outcomes
title Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
title_full Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
title_fullStr Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
title_full_unstemmed Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
title_short Sepsis Burden in a Major Romanian Emergency Center—An 18-Year Retrospective Analysis of Mortality and Risk Factors
title_sort sepsis burden in a major romanian emergency center an 18 year retrospective analysis of mortality and risk factors
topic sepsis
epidemiology
risk factors
comorbidities
mortality
outcomes
url https://www.mdpi.com/1648-9144/61/5/864
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