by Abu-Kaf, Heba;
Mizrakli, Yuval; Novack, Victor; Dreiher, Jacob
Objectives: Sepsis
remains a disease with a high mortality rate. The study goal was to assess
long-term survival of severe sepsis in young patients. Design: Retrospective
cohort study. Setting: Patients admitted with sepsis to ICUs in seven tertiary
hospitals between 2003 and 2011. Patients: A total of 409 patients less than 45
years who survived to hospital discharge were age and sex matched with 818
patients with infectious disease without sepsis selected from internal medicine
or surgical department admissions. Interventions: None. Measurements and Main
Results: The median age in sepsis patients and the comparison group was 31 and
32 years, respectively. The proportions of patients surviving after hospital
discharge were significantly lower in the sepsis group compared with the
control group; among survivors, 6-month, 1-year, and 3-year mortality rates
were 0.7% versus 0%, 4.5% versus 0.7%, 7.9% versus 1.2%, and 10.8% versus 1.8%,
respectively (p < 0.001 for all). In a multivariate Cox proportional hazards
regression model, sepsis was associated with an increased risk of mortality
(hazard ratio, 3.79; 95% CI, 2.27–6.32), while controlling for age, Charlson
Comorbidity Index, history of stroke, and congestive heart failure. Past the
24-month landmark, sepsis was not found to be an independent risk for mortality
(hazard ratio, 1.79; 95% CI, 0.67–4.79). Based on cause of death analysis,
chronic underlying comorbidities might explain the excess mortality in patients
with sepsis. Conclusions: Young patients experiencing an episode of severe
sepsis continue to be at higher risk of long-term mortality. The highest
mortality rates were observed during the first 24 months following discharge.
No comments:
Post a Comment