Late mortality after sepsis: propensity matched cohort study.

TitleLate mortality after sepsis: propensity matched cohort study.
Publication TypeJournal Article
Year of Publication2016
AuthorsPrescott, HC, Osterholzer, JJ, Langa, KM, Angus, DC, Iwashyna, TJ
JournalBMJ
Volume353
Paginationi2375
Date Published2016
ISSN Number1756-1833
KeywordsComorbidity, Hospitalization, Mortality, Pre-existing Conditions, Sepsis
Abstract

OBJECTIVES:  To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself.

DEIGN:  Observational cohort study.

SETTING:  US Health and Retirement Study.

PARTICIPANTS:  960 patients aged ≥65 (1998-2010) with fee-for-service Medicare coverage who were admitted to hospital with sepsis. Patients were matched to 777 adults not currently in hospital, 788 patients admitted with non-sepsis infection, and 504 patients admitted with acute sterile inflammatory conditions.

MAIN OUTCOME MEASURES:  Late (31 days to two years) mortality and odds of death at various intervals.

RESULTS:  Sepsis was associated with a 22.1% (95% confidence interval 17.5% to 26.7%) absolute increase in late mortality relative to adults not in hospital, a 10.4% (5.4% to 15.4%) absolute increase relative to patients admitted with non-sepsis infection, and a 16.2% (10.2% to 22.2%) absolute increase relative to patients admitted with sterile inflammatory conditions (P<0.001 for each comparison). Mortality remained higher for at least two years relative to adults not in hospital.

CONCLUSIONS:  More than one in five patients who survives sepsis has a late death not explained by health status before sepsis.

URLhttps://www.ncbi.nlm.nih.gov/pubmed/27189000
DOI10.1136/bmj.i2375
Alternate JournalBMJ
Citation Key8547
PubMed ID27189000
PubMed Central IDPMC4869794
Grant ListK08 GM115859 / GM / NIGMS NIH HHS / United States