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Published on: June 15, 2019
Late mortality after sepsis: propensity matched cohort study.
Hallie C Prescott1, John J Osterholzer2, Kenneth M Langa3
1Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA VA Center for Clinical Management Research, Health Services Research and DevelopmentCenter of Innovation, Ann Arbor, MI, USA Pulmonary Section, Medical Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Late mortality after sepsis is significantly higher, even after accounting for pre-existing conditions. Sepsis itself contributes to increased deaths for up to two years post-infection.
Area of Science:
- Gerontology
- Infectious Diseases
- Critical Care Medicine
Background:
- Late mortality following sepsis is a significant concern in elderly populations.
- Distinguishing sepsis-induced mortality from pre-existing conditions is crucial for effective patient management.
Purpose of the Study:
- To investigate whether late mortality after sepsis is primarily driven by pre-existing comorbidities or by the sepsis event itself.
- To quantify the excess mortality associated with sepsis in older adults.
Main Methods:
- An observational cohort study utilizing data from the US Health and Retirement Study.
- Analysis of 960 patients aged 65 and older admitted with sepsis, matched against control groups including those not hospitalized, with non-sepsis infections, and with sterile inflammatory conditions.
- Assessment of late mortality (31 days to two years) and odds of death.
Main Results:
- Sepsis was associated with a substantial absolute increase in late mortality compared to all control groups.
- Specifically, sepsis increased late mortality by 22.1% versus those not hospitalized, 10.4% versus non-sepsis infections, and 16.2% versus sterile inflammatory conditions.
- Elevated mortality rates persisted for at least two years post-sepsis compared to individuals not hospitalized.
Conclusions:
- A significant proportion of late deaths (over 20%) following sepsis survival are not attributable to pre-sepsis health status.
- Sepsis itself appears to be an independent driver of increased long-term mortality in older adults.
- These findings underscore the lasting impact of sepsis beyond the acute phase.
