One-year survival of patients admitted for sepsis to intensive care units in Colombia
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Published on: June 15, 2019
Henry Oliveros1, Eduardo Tuta-Quintero2, Mariana Piñeros3
1School of Medicine, Universidad de La Sabana, Km 7, Autonorte de Bogota, Chía, Cundinamarca, 250001, Colombia. henry.oliveros@unisabana.edu.co.
Insights
Sepsis significantly increases one-year mortality in intensive care units (ICUs), especially for older adults and those with comorbidities. This Colombian study highlights high sepsis-related deaths, emphasizing the need for targeted interventions to improve survival rates.
Area of Science:
- Critical Care Medicine
- Epidemiology
- Public Health
Background:
- Sepsis is a leading cause for intensive care unit (ICU) admissions globally.
- High mortality rates underscore the need for better survival data, particularly one-year survival rates in specific regions.
- Limited studies in Colombia have addressed long-term sepsis survival outcomes.
Purpose of the Study:
- To determine the one-year survival rate of patients admitted to Colombian ICUs due to sepsis.
- To compare the one-year survival of sepsis patients against those admitted for other critical conditions.
- To identify factors influencing one-year mortality in sepsis patients.
Main Methods:
- Retrospective cohort study utilizing administrative health databases from Colombia.
- Cox proportional hazards and inverse propensity score weighting models were employed.
- Analysis adjusted for comorbidities using the Charlson Index to determine hazard ratios for one-year survival.
Main Results:
- Out of 116,407 ICU admissions, 12,056 (10.36%) had sepsis.
- One-year mortality for sepsis patients was 36.73% (4,428 deaths).
- Key mortality predictors included age over 80 (HR 9.91), renal disease (HR 3.16), liver disease (HR 2.27), and cancer (HR 2.03). Male gender also showed increased risk.
Conclusions:
- A significant one-year mortality rate exists for sepsis patients in Colombian ICUs.
- Advanced age (over 80), renal disease, liver disease, and cancer are strong predictors of mortality.
- Male patients demonstrated higher mortality rates compared to female patients.
Background:
Sepsis is a frequent cause of admission to intensive care units (ICUs). High mortality rates are estimated globally, and in our country, few studies have reported one-year survival. The objective of this study is to determine one-year survival in patients with sepsis admitted to the ICU in Colombia, compared with the survival of patients admitted for other conditions.
Methods:
Retrospective cohort study using administrative databases from the Ministry of Health of Colombia. One-year survival and the adjusted hazard ratio for survival, adjusted for comorbidities included in the Charlson Index, were determined using a Cox proportional hazards model for patients admitted for other causes as well as for those admitted for sepsis. This was then compared with an inverse propensity score weighting model.
Results:
A total of 116.407 patients were initially admitted to the ICUs, with 12.056 (10.36%) diagnosed with sepsis. Within the first year, 4.428 (36.73%) patients died due to sepsis. Age and male gender were associated with an increased risk of death from sepsis, and the covariates associated with one-year mortality were as follows: age over 80 years with HR 9.91 (95% CI: 9.22-10.65), renal disease with HR 3.16 (95% CI: 3.03-3.29), primary tumoral disease with HR 2.07 (95% CI: 1.92-2.23), liver disease with HR 2.27 (95% CI: 2.07-2.50), and metastatic solid tumor with HR 2.03 (95% CI: 1.92-2.15).
Conclusion:
This study revealed a high one-year sepsis mortality rate in the population, associated with variables such as age over 80 years, the presence of renal disease, liver disease, connective tissue diseases, and cancer. Men exhibited higher mortality compared to women.
