Study on the differences in related organ dysfunction between surgical and non-surgical patients with sepsis

Yang Siyuan; Wu Tiesheng; Lin Junjie; Guo Liheng; He Jianzhuo

doi:10.3760/j.issn.1673-4777.2025.11.014

Abstract：Objective To investigate the difference of organ dysfunction between surgical and non-surgical patients with sepsis.Methods A total of 219 patients with sepsis admitted to the Department of Critical Care Medicine,Guangdong Provincial Hospital of Traditional Chinese Medicine from January 1,2021 to January 1,2024 were retrospectively selected as the research objects.According to whether they received surgical treatment,they were divided into surgery group(71 cases)and non-surgery group(148 cases).Univariate analysis was used to screen out the factors with significant differences between surgical and non-surgical patients with sepsis,and multivariate Logistic analysis was used to analyze the influencing factors of non-surgical patients with sepsis.The Kaplan-Meier method was used to draw the survival analysis curve of patients with sepsis in the surgery group and the non-surgery group,and the influence of different surgical types on the survival rate of patients with sepsis was analyzed.The survival group and death group of patients with sepsis in the surgery group and the non-surgery group were analyzed.Results There were statistically significant differences in the proportions of pulmonary infection,digestive tract infection,blood infection,skin and soft tissue infection,hypertension,cerebrovascular disease,chronic kidney disease,and malignant tumors between the two groups(all P＜0.05).There were significant differences in sequential organ failure assessment(SOFA)score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ)score,vasopressin use proportion,white blood cell count,prothrombin time,activated partial thromboplastin time(APTT),SOFA liver subscore,serum total bilirubin,SOFA circulation subscore,and vasopressin treatment days between the two groups(all P＜0.05).Multivariate Logistic regression analysis showed that APTT,SOFA liver subscore and SOFA cardiovascular subscore were negatively correlated with non-surgical sepsis(odds ratio=0.969,0.587,0.724,all P＜0.05).The survival rate of emergency surgery was significantly lower than that of limited surgery(x2=4.089,P=0.043).Subgroup analysis showed that SOFA score,APACHEⅡ score,SOFA renal subscore,the use of mechanical ventilation and renal replacement therapy on the first day in the surgery group were all influencing factors for in-hospital mortality(all P＜0.05).SOFA score,APACHE Ⅱ score,SOFA respiratory subscore,SOFA central subscore,the use of mechanical ventilation and renal replacement therapy on the first day were the influencing factors of in-hospital mortality in non-surgery group(all P＜0.05).Conclusions Compared with non-surgical sepsis patients,surgical sepsis patients show more severe organ dysfunction on admission to the intensive care unit,mainly in the cardiovascular system and liver system,but there is no significant difference in short-term prognosis between the two groups.