Risk factors of acute kidney injury, septic shock and acute respiratory distress syndrome in patients with blood culture-positive sepsis

Sepsis, a condition characterized by a dysregulated host response to infection, can progress to septic shock and lead to various complications. The present study aimed to identify risk factors for the early clinical identification of sepsis patients at heightened risk of complications. In the present study, a total of 383 hospitalized patients with sepsis and positive blood cultures were enrolled. Demographic characteristics, laboratory findings at admission and treatment outcomes were collected and analyzed. Among the 383 sepsis patients, 165 were diagnosed with acute kidney injury (AKI). Patients with AKI exhibited significantly lower platelet counts, elevated procalcitonin levels and higher Sequential Organ Failure Assessment (SOFA) scores. Logistic regression analysis identified the SOFA score [odds ratio (OR)=1.269, 95% confidence interval (CI): 1.067-1.510, P=0.007) as an independent predictor of AKI. Furthermore, patients with septic shock had lower platelet counts and higher white blood cell counts at admission. Multivariable analysis revealed that age (OR=1.024, 95% CI: 1.001-1.047, P=0.039), procalcitonin (OR=1.018, 95% CI: 1.003-1.032, P=0.015), SOFA score (OR=1.465, 95% CI: 1.248-1.719, P<0.001) and Pitt bacteremia score (OR=1.437, 95% CI: 1.204-1.716, P<0.001) were independently associated with septic shock. In addition, sepsis patients with acute respiratory distress syndrome (ARDS) were observed to have lower platelet counts, higher body weight and elevated alanine aminotransferase levels. Multivariable analysis identified the SOFA score (OR=1.177, 95% CI: 1.095-1.265, P<0.001) and body weight (OR=1.030, 95% CI: 1.007-1.054, P=0.010) as independent predictors of ARDS. The present study highlights the risk factors associated with AKI, ARDS and septic shock in sepsis patients with positive blood cultures. Early identification and close monitoring of these factors are crucial for improving outcomes in sepsis management.