Comparison of outcomes of community-acquired sepsis and hospital-acquired sepsis in critically ill patients: a systematic review and meta-analysis.

Background: Subgrouping sepsis by the location of onset, such as hospital-acquired sepsis or community-acquired sepsis, aids in clinical management, planning future interventional studies, and the formulation of healthcare policies. The aim of our study is to describe differences in clinical outcomes between hospital and community-acquired sepsis admitted to critical care units. Patients and methods: PubMed, Embase, and Google Scholar were systematically searched from inception to February 2024. Any observational studies comparing the outcomes of adult patients (≥18 years) admitted to the intensive care unit (ICU) with community-acquired sepsis and hospital-acquired sepsis were included in the analysis. The primary outcome assessed by our study was the risk of mortality in the patients, calculated as a pooled odd's ratio with a 95% confidence interval (CI). Other secondary outcomes, like length of stay in the ICU, and length of overall hospital stay, were also extracted and studied. Results: The risk of death in patients with hospital-acquired sepsis was significantly higher than that in patients with community-acquired sepsis (OR = 2.19, 95% CI = 1.82-2.63, Conclusions: The risk of mortality, the length of ICU stay and overall hospital stay was significantly higher in hospital-acquired sepsis compared to community-acquired sepsis.