Factors relating to mortality in septic patients in Vietnamese intensive care units from a subgroup analysis of MOSAICS II study

Do, Son Ngoc; Luong, Chinh Quoc; Pham, Dung Thi; Nguyen, My Ha; Nguyen, Nga Thi; Huynh, Dai Quang; Hoang, Quoc Trong Ai; Dao, Co Xuan; Le, Trung Minh; Bui, Ha Nhat; Nguyen, Hung Tan; Hoang, Hai Bui; Le, Thuy Thi Phuong; Nguyen, Lien Thi Bao; Duong, Phuoc Thien; Nguyen, Tuan Dang; Vu, Yen Hai; Pham, Giang Thi Tra; Van Bui, Tam; Pham, Thao Thi Ngoc; Hoang, Hanh Trong; Van Bui, Cuong; Nguyen, Nguyen Minh; Bui, Giang Thi Huong; Vu, Thang Dinh; Le, Nhan Duc; Tran, Trang Huyen; Nguyen, Thang Quang; Le, Vuong Hung; Van Nguyen, Chi; McNally, Bryan Francis; Phua, Jason; Nguyen, Anh Dat

Sepsis is the most common cause of in-hospital deaths, especially from low-income and lower-middle-income countries (LMICs). This study aimed to investigate the mortality rate and associated factors from sepsis in intensive care units (ICUs) in an LMIC. We did a multicenter cross-sectional study of septic patients presenting to 15 adult ICUs throughout Vietnam on the 4 days representing the different seasons of 2019. Of 252 patients, 40.1% died in hospital and 33.3% died in ICU. ICUs with accredited training programs (odds ratio, OR: 0.309; 95% confidence interval, CI 0.122–0.783) and completion of the 3-h sepsis bundle (OR: 0.294; 95% CI 0.083–1.048) were associated with decreased hospital mortality. ICUs with intensivist-to-patient ratio of 1:6 to 8 (OR: 4.533; 95% CI 1.621–12.677), mechanical ventilation (OR: 3.890; 95% CI 1.445–10.474) and renal replacement therapy (OR: 2.816; 95% CI 1.318–6.016) were associated with increased ICU mortality, in contrast to non-surgical source control (OR: 0.292; 95% CI 0.126–0.678) which was associated with decreased ICU mortality. Improvements are needed in the management of sepsis in Vietnam such as increasing resources in critical care settings, making accredited training programs more available, improving compliance with sepsis bundles of care, and treating underlying illness and shock optimally in septic patients.