Impact of abdominal aortic calcification on 90‐day mortality in sepsis patients: a pilot retrospective cohort study

• Published in: Acute Medicine & Surgery Vol. 8; no. 1; pp. e630 - n/a
• Main Authors: Kato, Takayuki, Fujino, Kazunori, Tsujita, Yasuyuki, Miyatake, Hidemitsu, Tabata, Takahisa, Eguchi, Yutaka
• Format: Journal Article
• Language: English
• Published: United States Wiley 01.01.2021; John Wiley & Sons, Inc; John Wiley and Sons Inc
• Subjects: Abdomen; Abdominal aorta; Age; Calcification; Cohort analysis; Confidence intervals; Coronary vessels; Diabetes; Hemodialysis; Hypertension; Intensive care; Medical emergencies. Critical care. Intensive care. First aid; Medical prognosis; Mortality; Original; Patients; Physiology; prognosis; RC86-88.9; Sepsis; Smoking; vascular calcification; Abdominal aorta; mortality; prognosis; sepsis; vascular calcification
• ISSN: 2052-8817; 2052-8817
• DOI: 10.1002/ams2.630

Aim We aimed to investigate the association between aortic calcification and 90‐day mortality in sepsis patients admitted to the intensive care unit. Methods We evaluated adult patients (≥18 years) diagnosed with sepsis based on the Sepsis‐3 criteria and admitted to our intensive care unit between April 2011 and March 2015. They were classified according to the degree of abdominal aortic calcification (severe and non‐severe), grouped per age (<65, 65–75, and >75 years), and matched. Survival curves were generated, and between‐group differences were evaluated. Results Overall, 164 patients were included. The Acute Physiology and Chronic Health Evaluation II and Sequential Organ Failure Assessment scores were not significantly different between the severity groups, whereas there were significant differences in age (P < 0.001), sex (P = 0.017), and presence of diabetes mellitus (P < 0.001), hypertension (P < 0.001), dyslipidemia (P = 0.048), and maintenance dialysis (P = 0.001). The severe abdominal aortic calcification group showed significantly poorer prognosis than the non‐severe group (log–rank P = 0.009). The adjusted odds ratio of severe calcification was the highest in patients aged <65 years (7.167; 95% confidence interval, 1.042–49.28, P = 0.045). Twenty‐eight patients from each group were matched. The 90‐day survival rate of the severe calcification group remained significantly lower than that of the non‐severe calcification group (53.6% [15/28] versus 82.1% [23/28], P = 0.022). Conclusions Severe abdominal aortic calcification is associated with the 90‐day mortality of sepsis patients, particularly among those aged <65 years. Thus, caution is necessary in patients younger than 65 years; they may need to be treated with as much care as the elderly. We investigated the association between aortic calcification and the 90‐day prognosis of patients with intensive care unit admission for sepsis. Propensity score matching was used to minimize the effect of confounding factors (e.g., diabetes mellitus) that could lead to biased results. Severe aortic calcification (not calcification only) was associated with a 90‐day prognosis in patients with intensive care unit admission sepsis, especially those younger than 65 years of age.