Logo Medical Science Monitor

Call: +1.631.470.9640
Mon - Fri 10:00 am - 02:00 pm EST

Contact Us

Logo Medical Science Monitor Logo Medical Science Monitor Logo Medical Science Monitor

29 December 2020 : Database Analysis  

Prognosis of Patients with Sepsis and Non-Hepatic Hyperammonemia: A Cohort Study

Lina Zhao1ACDE, Yanxia Gao2B, Shigong Guo3BE, Xin Lu1B, Shiyuan Yu1B, Zengzheng Ge1B, Huadong Zhu1B, Yi Li1AE*

DOI: 10.12659/MSM.928573

Med Sci Monit 2020; 26:e928573

Abstract

BACKGROUND: Hyperammonemia has been reported in some critically ill patients with sepsis who do not have hepatic failure. A significant proportion of patients with non-hepatic hyperammonemia have underlying sepsis, but the association between non-hepatic hyperammonemia and prognosis is unclear.

MATERIAL AND METHODS: Information about patients with sepsis and non-hepatic hyperammonemia was retrieved from the Medical Information Mart for Intensive Care-III database. Survival rates were analyzed using the Kaplan-Meier method. Multivariate logistic regression models were employed to identify prognostic factors. Receiver operating characteristic (ROC) curve analysis was used to measure the predictive ability of ammonia in terms of patient mortality.

RESULTS: A total of 265 patients with sepsis were enrolled in this study. Compared with the non-hyperammonemia group, the patients with hyperammonemia had significantly higher rates of hospital (59.8% vs. 43.0%, P=0.007), 30-day (47.7% vs. 34.8%, P=0.036), 90-day (61.7% vs. 43.7%, P=0.004), and 1-year mortality (67.3% vs. 49.4%, P=0.004). In the survival analysis, hyperammonemia was associated with these outcomes. Serum ammonia level was an independent predictor of hospital mortality. The area under the ROC curve for the ammonia levels had poor discriminative capacity. The hyperammonemia group also had significantly lower Glasgow Coma Scale scores (P=0.020) and higher incidences of delirium (15.9% vs. 8.2%, P=0.034) and encephalopathy (37.4% vs. 19.6%, P=0.001). Intestinal infection and urinary tract infection with organisms such as Escherichia coli may be risk factors for hyperammonemia in patients who have sepsis.

CONCLUSIONS: Higher ammonia levels are associated with poorer prognosis in patients with sepsis. Ammonia also may be associated with sepsis-associated encephalopathy. Therefore, we recommend that serum ammonia levels be measured in patients who are suspected of having sepsis.

Keywords: Escherichia coli Infections, hyperammonemia, Sepsis, APACHE, Ammonia, Area Under Curve, Brain Diseases, Cohort Studies, Critical Illness, Escherichia coli, Hospital Mortality, Intensive Care Units, Organ Dysfunction Scores, ROC Curve, Risk Factors, Urinary Tract Infections

Add Comment 0 Comments

Editorial

01 February 2025 : Editorial  

Editorial: Current Approaches to Screening for Lung Cancer in Smokers and Non-Smokers

Dinah V. Parums

DOI: 10.12659/MSM.948255

Med Sci Monit 2025; 31:e948255

0:00

In Press

Clinical Research  

Predicting Cerebral Small Vessel Disease Burden Based on Thromboelastography in Patients with Acute Ischemi...

Med Sci Monit In Press; DOI: 10.12659/MSM.946303  

Clinical Research  

Long-Term Outcomes of Implanon in Managing Adenomyosis: A 3-Year Prospective Study

Med Sci Monit In Press; DOI: 10.12659/MSM.945972  

Laboratory Research  

Linear Dimensional Accuracy in Maxillomandibular Records: A Comparative Study of Scannable and Transparent ...

Med Sci Monit In Press; DOI: 10.12659/MSM.947265  

Clinical Research  

Efficacy of King's Combined Uterine Suture in Managing Placenta Accreta: A Retrospective Analysis

Med Sci Monit In Press; DOI: 10.12659/MSM.945826  

Most Viewed Current Articles

17 Jan 2024 : Review article   6,969,932

Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron Variant

DOI :10.12659/MSM.942799

Med Sci Monit 2024; 30:e942799

0:00

16 May 2023 : Clinical Research   701,896

Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...

DOI :10.12659/MSM.940387

Med Sci Monit 2023; 29:e940387

0:00

01 Mar 2024 : Editorial   25,741

Editorial: First Regulatory Approvals for CRISPR-Cas9 Therapeutic Gene Editing for Sickle Cell Disease and ...

DOI :10.12659/MSM.944204

Med Sci Monit 2024; 30:e944204

0:00

28 Jan 2024 : Review article   20,253

A Review of IgA Vasculitis (Henoch-Schönlein Purpura) Past, Present, and Future

DOI :10.12659/MSM.943912

Med Sci Monit 2024; 30:e943912

0:00

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750