Late mortality after sepsis: propensity matched cohort study
bmj, 2016•bmj.com
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�…
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�…
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.
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