pre-hospital prognostic factors of 30-day survival in sepsis patients; a retrospective cohort study

Introduction: according to excising findings, if the emergency management system (ems) operation will be developed, the survival outcome of sepsis patients might improve. this study aimed to evaluate the pre-hospital associated factors of survival in sepsis patients. methods: this retrospective cohort study was conducted on patients diagnosed with sepsis, coded with the thailand emergency medical triage protocol and criteria-based dispatch symptom group 17. information on the 30-day survival rate of patients was obtained from the electronic medical records. pre-hospital factors associated with 30-day survival were analyzed using univariate and multivariate logistic regression analyses and were reported using odds ratio (or) with 95% confidence interval (ci). results: 300 patients diagnosed with sepsis were enrolled. among them, 232 (77.3%) survived within 30 days. non-survived cases had significantly older age (p = 0.019), lower oxygen saturations (92.5% vs. 95.0%; p = 0.003), higher heart rate (p = 0.001), higher respiratory rate (p < 0.001), lower level of consciousness (p < 0.001), higher disease severity based on qsofa score (p = 0.001), and higher need for invasive airway management (p = 0.001) and supplementary oxygen (p = 0.001). the survival rate improved by 3.5% with every 1% increase in pre-hospital oxygen saturation (adjusted or = 1.035, 95% ci: 1.005–1.066, p = 0.020) and the survival probabilities of patients who responded to voice (adjusted or = 0.170, 95% ci: 0.050–0.579, p = 0.005), those who responded to pain (adjusted or = 0.130, 95% ci: 0.036–0.475, p = 0.002), and those who were unresponsive (adjusted or = 0.086, 95% ci: 0.026–0.278, p-value < 0.001) were lower than patients who were alert. conclusion: the 30-day survival rate of patients with sepsis managed by the ems team was 77.3%. pre-hospital oxygen saturation and level of consciousness were associated with the survival of patients with sepsis who were managed in the pre-hospital setting.