Abstract
In order to reduce sepsis mortality, early treatment implementation and referral to the most appropriate ward (emergency department (ED) or intensive care unit (ICU) are recommended. This multicentre retrospective study aims to study the relationship between 30-day mortality and the admission mode to ICU or ED among patients with septic shock cared for by a prehospital mobile Intensive Care Unit (mobile-ICU). From May 2016 to December 2022, septic shock patients cared for by a prehospital mobile-ICU were retrospectively analysed. To assess the relationship between 30-day mortality rate and the admission mode, a multivariate logistic regression after Inverse Probability Treatment Weighting (IPTW) propensity score matching was performed. Among the 587 patients analysed, pulmonary, urinary and digestive infections were the main septic shock aetiology: 42%, 26% and 17% respectively. The overall 30-day mortality rate was 30%. Three-hundred and twenty-seven patients (58%) were admitted to ICU and 260 (42%) to the ED. On matched population, the multivariate analysis including the followings potential confounders: prehospital fluid expansion, norepinephrine administration, broad-spectrum antibiotic therapy, age, chronic obstructive pulmonary disease, chronic kidney disease, diabetes mellitus, cancer history, hypertension, chronic heart failure, coronary artery disease, hospitalization in the previous 3 months, SAPS-2, management in rural area and prehospital duration, an aRR=1.05 [1.00-1.09] (p=0.025) between 30-day mortality and ED admission. Conversely, the multivariate analysis with the same confounders found aRR=0.90 [0.86-0.95] between 30-day mortality and ICU admission. This study highlighted a positive relationship between ED admission and 30-day mortality of patients in septic shock cared for by a prehospital mobile-ICU suggesting a possible negative effect of ED admission whereas a direct ICU admission may be beneficial.
Similar content being viewed by others
Abbreviations
- mobile-ICU:
-
Mobile intensive care unit
- ICU:
-
Intensive care unit intervention
- MAP:
-
Mean arterial pressure
- SS:
-
Septic shock
- SAMU:
-
Urgent medical aid service
- SMUR:
-
Mobile Emergency and Resuscitation Service
- ED:
-
Emergency department
- SAP:
-
Systolic arterial pressure
- DAP:
-
Diastolic arterial pressure
- HR:
-
Heart rate
- SpO2:
-
Pulse oximetry
- RR:
-
Respiratory rate
- GCS:
-
Glasgow coma scale
- LOS:
-
Length of stay
- SAPS 2:
-
Simplified acute physiology score
- IPTW:
-
Inverse Probability treatment weighting
- aHR:
-
Adjusted hazard ratio
Acknowledgements
All methods were carried out in accordance with the Declaration of Helsinki. The French Society of Anaesthesia and Intensive Care ethics committee considered that consent of patients was waived for participation in this observational study
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethics approval and consent to participate
The study was approved by the French Society of Anaesthesia and Intensive Care ethics committee on 2017, December 12th (Ref number: IRB 00010254-2017-026).
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Jouffroy, R., Garrouste, V., Gilbert, B. et al. Direct admission to the intensive care unit for patients with prehospital septic shock is associated with a lower 30-day mortality rate. Sci Rep (2026). https://doi.org/10.1038/s41598-026-49834-z
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-49834-z
