ArticleBMC infectious diseases2026
Predicting 28-day and 90-day mortality in microbiologically-confirmed sepsis: a retrospective cohort study.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveSepsis patients with confirmed microbial infection represent a clinically important subgroup requiring specialized prognostic tools, though existing models fail to address their unique characteristics. SELECTING AND
methodsA retrospective analysis was conducted using the MIMIC-IV repository, selecting adult sepsis cases fulfilling sepsis-3.0 criteria with microbiological confirmation. Primary endpoints were 28- and 90-day all-cause mortality. Analytical approaches included nonparametric comparative tests, stepwise survival regression modeling, and comprehensive sensitivity evaluations.
resultsOur analysis encompassed 5,694 patients with culture-confirmed sepsis, demonstrating mortality rates of 15.8% (28-day) and 17.5% (90-day), respectively. Multivariable regression identified significant mortality predictors (all p < 0.001), including age, respiratory rate, hemoglobin, lactate levels, vasoactive drug use, CCI, LODS score, SIRS score, SAPS III, and OASIS. These variables were incorporated into model 2 and model 4, both of which demonstrated strong predictive performance for 28-day and 90-day mortality with model 2 (AUC: 0.798; specificity: 0.765; sensitivity: 0.678) and model 4 (AUC: 0.795; specificity: 0.730; sensitivity: 0.708). Both models demonstrated consistent predictive performance in subgroup analyses. However, no significant association was observed between infection site, pathogenic microorganism type, and patient prognosis (p ≥ 0.05).
conclusionThese findings establish clinically applicable risk stratification tools specifically designed for culture-positive sepsis, potentially enabling more tailored therapeutic decisions for this vulnerable patient cohort. CLINICAL TRIAL NUMBER: Not applicable.
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