Background: The main aim of the study was to analyse characteristics of sepsis according to the setting of occurrence and to identify predictors of sepsis-related in-hospital mortality. Methods: 544 medical records of adult patients with a diagnosis of sepsis were consulted and divided into two groups according to the setting where sepsis originated: community-acquired (CA) and healthcare-associated (HA) sepsis. Results: Overall, 257 (47.2%) patients had HA sepsis and the in-hospital death rate was 33.6%. Results of the multiple logistic regression revealed that patients with HA sepsis were significantly more likely to have been admitted from another hospital or ward, to have a ≥1 Charlson's index, to be immunesuppressed, and to have undergone a surgical intervention during hospitalization. In-hospital deaths were significantly associated with older age, admission from another hospital or ward, need of haemodialysis and mechanical ventilation (MV), whereas they were less likely in patients with HA sepsis as compared with CA sepsis. Conclusion: Community-acquired and HA sepsis show distinct clinical, prognostic and risk factors profiles, and should be managed according to their differential characteristics.

中文翻译：

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社区获得性和医疗相关性脓毒症：意大利的特征和住院死亡率。

背景：本研究的主要目的是根据脓毒症的发生情况分析脓毒症的特征，并确定与脓毒症相关的院内死亡率的预测因素。方法：查阅544例诊断为败血症的成年患者的病历，并根据其发生败血症的情况分为两组：社区获得性（CA）败血症和与医疗相关的（HA）败血症。结果：共有257名（47.2％）患者患有HA败血症，院内死亡率为33.6％。多元logistic回归分析的结果显示，患有HA脓毒症的患者更有可能被另一家医院或病房收治，Charlson指数≥1，免疫抑制以及住院期间接受了外科手术。院内死亡与年龄较大，从另一家医院或病房入院，需要血液透析和机械通气（MV）显着相关，而与CA败血症相比，HA败血症患者的死亡可能性较小。结论：社区获得性和HA败血症表现出不同的临床，预后和危险因素特征，应根据其差异特征进行管理。