Septic shock in adults with type 2 Diabetes Mellitus: Analysis of mortality predictors

Abstract

Introduction: Septic shock is one of the leading causes of hospital mortality worldwide, and sepsis is a significant cause of morbidity and mortality. Patients with type 2 diabetes have a higher susceptibility to severe infections due to immunological alterations, persistent hyperglycemia, and endothelial dysfunction, conditions that promote the development of sepsis and lethality.

Objective: Identify factors associated with and predictors of mortality in adults with type 2 diabetes and septic shock treated in the emergency department of a social security clinic.

Material and methods: Descriptive, analytical unmatched case-control study based on the review of patient medical records, using a sample of 142 medical records. The selection was carried out using simple random probabilistic sampling, employing a table of random numbers from the sampling frame.

Results: A significant association was observed between the focus of infection and mortality (χ²=8.67; df=3; p=0.034), as well as between the type of comorbidity and clinical outcome (mortality) (χ²=10.09; df=3; p=0.050). Significant differences in age were identified between patients who died and those who improved (U=1811.00; p=0.004). In the multivariate analysis, age behaved as an independent predictor of mortality (OR=1.03; 95% CI: 1.005–1.057; p=0.023), while sex showed a trend toward association without reaching statistical significance.

Discussion and Conclusions: Age was identified as an independent predictor of mortality in patients with type 2 diabetes diagnosed with septic shock treated in the emergency department. The presence of comorbidities and the focus of infection were associated with mortality in the bivariate analysis.