Effect of treatment applied in sepsis on intensive care unit and hospital stay: how effective are albumin/steroid/vasopressor agents?

Background
The incidence and prevalence of sepsis have increased in recent years and it is the most common cause of intensive care admission. The aim of this study was to determine the effects of albumin, steroid, and vasopressor agents and other possible factors on the duration of intensive care unit and hospital stay in sepsis patients. Open access data set obtained from Tohoku Sepsis Registry database was used. Four hundred sixty-two patients admitted to intensive care unit with the diagnosis of sepsis were divided into four groups according to their intensive care unit (≤ 5 or > 5 days) and hospital length of stay (≤ 24 or > 24 days). Demographic data, vital signs, laboratory values, mechanical ventilation requirement, and treatment protocols such as albumin, steroid, and vasopressor agent use were used in the evaluation of the groups.
Results
The use of albumin (odds ratio [OR] = 3.76 [95% confidence interval (CI), 2.16–6.56]; < 0.001), steroids (OR = 2.85 [95% CI, 1.67–4.86]; < 0.001), and vasopressor agents (OR = 3.56 [95% CI, 2.42–5.24]; < 0.001) were associated with an increasing risk of prolonged intensive care unit length of stay. Also, it was found that the use of albumin (OR = 3.43 [95% CI, 2.00–5.89]; < 0.001), steroids (OR = 2.81 [95% CI, 1.66–4.78]; < 0.001), and vasopressor agents (OR = 4.47 [95% CI, 3.02–6.62]; < 0.001) were associated with an increasing risk of prolonged hospital length of stay. In addition, prognostic scoring systems, body temperature, mean arterial pressure, pH, PaO/FiO ratio, and mechanical ventilation requirement in the first 24 h were also found to be associated with length of stay in intensive care unit and hospital. There was a significant relationship between platelet count, creatinine, Na, lactic acid, and time between diagnosis of sepsis and source control and intensive care unit length of stay, and between hematocrit and C-reactive protein and hospital length of stay.
Conclusions
The use of albumin, steroid, and vasopressor agents has been found to be significantly correlated with both intensive care unit and hospital length of stay. Further studies are needed to determine in what order or at what dosage these agents will be administered in sepsis treatment.