Long-Term Mortality and Major Adverse Cardiovascular Events in Sepsis Survivors. A Nationwide Population-based Study

Ou, Shuo Ming; Chu, Hee Ho; Chao, Pei Wen; Lee, Yi Jung; Kuo, Shu‐Chen; Chen, Tzeng Ji; Tseng, Ching Min; Shih, Chwen Ming; Chen, Yung Tai

doi:10.1164/rccm.201510-2023oc

Cited by 169 publications

(151 citation statements)

References 46 publications

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“…A recent controlled study showed that late excess mortality was higher in patients with 3 or more organ dysfunctions, even after adjusting for acute mortality differences [141]. Another recent study observed these [141] effects were significantly higher in male patients, younger patients, those with higher Charlson Comorbidity Index scores, those with higher numbers of organ failure, those admitted to intensive care units, those with shock, and those who required mechanical ventilatory support [142].…”

Section: What Are the Predictors Of Sepsis Long-term Morbidity And Momentioning

confidence: 99%

“…One study showed that mortality was increased, compared with matched non-hospitalized controls, non-septic infected hospitalized patients and patients admitted with sterile inflammatory conditions [141]. Another study demonstrated that septic patients had higher mortality than matched controls from the general population and subjects who were hospitalized for a non-septic cause [142]. Data from newer cohorts with appropriate controls have also shown that sepsis survivors have a higher risk of hospital readmission which is associated with an increased risk of death [143][144][145].…”

Section: Post-icumentioning

confidence: 99%

“…Disability rates also appear to be increased for years in survivors of sepsis compared to their pre-ICU levels, at least among older Americans and are high in many populations, driving poor measured healthrelated quality of life [148,[155][156][157][158]. While there have been no systematic efforts to map the specific conditions for which septic patients are at increased risk, there are suggestions of increased rates of malignancy, readmissions for a new sepsis episode, high rates of new cardiovascular diseases and residual immune dysregulations [142,143,[159][160][161][162][163]. Many septic patients develop new comorbidities such as chronic kidney failure, the mechanisms of which may be different than in patients with non-septic acute kidney injury [164].…”

Section: Post-icumentioning

confidence: 99%

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Surviving sepsis campaign: research priorities for sepsis and septic shock

et al. 2018

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Objective: To identify research priorities in the management, epidemiology, outcome and underlying causes of sepsis and septic shock.Design: A consensus committee of 16 international experts representing the European Society of Intensive Care Medicine and Society of Critical Care Medicine was convened at the annual meetings of both societies. Subgroups had teleconference and electronic-based discussion. The entire committee iteratively developed the entire document and recommendations.Methods: Each committee member independently gave their top five priorities for sepsis research. A total of 88 suggestions (ESM 1 -supplemental table 1) were grouped into categories by the committee co-chairs, leading to the formation of seven subgroups: infection, fluids and vasoactive agents, adjunctive therapy, administration/epidemiology, scoring/identification, post-intensive care unit, and basic/translational science. Each subgroup had teleconferences to go over each priority followed by formal voting within each subgroup. The entire committee also voted on top priorities across all subgroups except for basic/translational science. Results:The Surviving Sepsis Research Committee provides 26 priorities for sepsis and septic shock. Of these, the top six clinical priorities were identified and include the following questions: (1) can targeted/personalized/precision medicine approaches determine which therapies will work for which patients at which times?; (2) what are ideal endpoints for volume resuscitation and how should volume resuscitation be titrated?; (3) should rapid diagnostic tests be implemented in clinical practice?; (4) should empiric antibiotic combination therapy be used in sepsis or septic shock?; (5) what are the predictors of sepsis long-term morbidity and mortality?; and (6) what information identifies organ dysfunction?Conclusions: While the Surviving Sepsis Campaign guidelines give multiple recommendations on the treatment of sepsis, significant knowledge gaps remain, both in bedside issues directly applicable to clinicians, as well as understanding the fundamental mechanisms underlying the development and progression of sepsis. The priorities identified represent a roadmap for research in sepsis and septic shock.

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Section: What Are the Predictors Of Sepsis Long-term Morbidity And Momentioning

confidence: 99%

Section: Post-icumentioning

confidence: 99%

Section: Post-icumentioning

confidence: 99%

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Surviving sepsis campaign: research priorities for sepsis and septic shock

et al. 2018

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“…In the only population-based study investigating 1-year mortality and cause of death, Dekker et al observed that mortality increased with age and 25% of deaths were attributable to complications among 1924 patients who underwent stage I-III colorectal cancer resection in The Netherlands (Dekker et al, 2014). Furthermore, older patients may be at higher risk for septic complications, and there is increasing evidence that sepsis is associated with worse long-term survival following colorectal cancer surgery as well as an increased risk of cardiovascular events due to a sepsis-mediated systemic inflammatory response (Yende et al, 2014;Aquina et al, 2016a;Ou et al, 2016;Park et al, 2016). However, no similar studies to date have been performed in the United States.…”

mentioning

confidence: 99%

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Aquina

Mohile

Tejani

et al. 2016

JCO

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“…For the overall cohort, the median number of days in a healthcare facility doubled from 5 in the year prior to sepsis, to 10 in the year after sepsis—suggesting that the healthcare utilization in the year after sepsis is not merely a reflection of sepsis survivors’ age, co-morbidity burden, or propensity to use healthcare, but is also a reflection of new disability 5 and heightened risk for medical deterioration after sepsis, such as recurrent infections 16–18 , acute renal failure 17 , aspiration 17,19 , and cardiovascular events 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Increased healthcare facility use in veterans surviving sepsis hospitalization

DeMerle

Vincent

Iwashyna

et al. 2017

Journal of Critical Care

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Purpose We sought to measure inpatient healthcare utilization among U.S. Veteran Affairs beneficiaries surviving sepsis hospitalization, and to examine how post-sepsis utilization varies by select patient characteristics. Materials and Methods Retrospective cohort study of 26,561 Veterans who survived sepsis hospitalization in 2009. Using difference-in-differences analysis, we compared changes in healthcare utilization in one year before and one year after sepsis hospitalization by Veteran age, illness severity, and recent nursing facility use. Results Median days in a healthcare facility increased from 5 to 10. Veterans with recent nursing facility use spent a median 65 days (or 86% of days alive) in a healthcare facility in the year after sepsis. Older age, greater illness severity, and recent nursing home use were each associated with spending more days, and a greater proportion of days alive, in a healthcare facility during the year after sepsis. However, none of these characteristics was associated with a greater rise in utilization after sepsis. Conclusions Veterans surviving sepsis experience high rates of post-sepsis mortality and significant increases in healthcare facility use. Recent nursing facility use is strongly predictive of greater post-sepsis healthcare utilization.

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Long-Term Mortality and Major Adverse Cardiovascular Events in Sepsis Survivors. A Nationwide Population-based Study

Abstract: These data indicate that sepsis survivors had substantially increased risks of subsequent all-cause mortality and major adverse cardiovascular events at 1 year after discharge, which persisted for up to 5 years after discharge.

Cited by 169 publications

References 46 publications

Surviving sepsis campaign: research priorities for sepsis and septic shock

Surviving sepsis campaign: research priorities for sepsis and septic shock

The impact of age on complications, survival, and cause of death following colon cancer surgery.

Increased healthcare facility use in veterans surviving sepsis hospitalization

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