Davis JS; He V; Anstey NM; Condon JR

Author(s)

Davis JS

He V

Anstey NM

Condon JR

Publication Date

2014-12-08

Abstract

Sepsis is a leading cause of death in intensive care units and is increasing in incidence. Current trials of novel therapeutic approaches for sepsis focus on 28-day mortality as the primary outcome measure, but excess mortality may extend well beyond this time period. We used relative survival analysis to examine excess mortality in a cohort of 1,028 patients admitted to a tertiary referral hospital with sepsis during 2007-2008, over the first 5 years of follow up. Expected survival was estimated using the Ederer II method, using Australian life tables as the reference population. Cumulative and interval specific relative survival were estimated by age group, sex, sepsis severity and Indigenous status. Patients were followed for a median of 4.5 years (range 0-5.2). Of the 1028 patients, the mean age was 46.9 years, 52% were male, 228 (22.2%) had severe sepsis and 218 (21%) died during the follow up period. Mortality based on cumulative relative survival exceeded that of the reference population for the first 2 years post admission in the whole cohort and for the first 3 years in the subgroup with severe sepsis. Independent predictors of mortality over the whole follow up period were male sex, Indigenous Australian ethnicity, older age, higher Charlson Comorbidity Index, and sepsis-related organ dysfunction at presentation. The mortality rate of patients hospitalised with sepsis exceeds that of the general population until 2 years post admission. Efforts to improve outcomes from sepsis should examine longer term outcomes than the traditional primary endpoints of 28-day and 90-day mortality.

Affiliation

Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Australia..

Menzies School of Health Research, Charles Darwin University, Darwin, Australia..

Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Australia..

Menzies School of Health Research, Charles Darwin University, Darwin, Australia..

Citation

PloS one 2014; 9(12): e112224

Pubmed ID

https://pubmed.ncbi.nlm.nih.gov/25486241/?otool=iaurydwlib

Link

https://hdl.handle.net/10137/5531

MESH subject

Adult

Aged

Cohort Studies

Comorbidity

Female

Follow-Up Studies

Hospital Mortality

Humans

Intensive Care Units

Male

Middle Aged

Patient Outcome Assessment

Sepsis

Survival Analysis

Hospitalization

Title

Long term outcomes following hospital admission for sepsis using relative survival analysis: a prospective cohort study of 1,092 patients with 5 year follow up.

Type of document

Journal Article

Entity Type

Publication

Author(s)	Davis JS He V Anstey NM Condon JR
Publication Date	2014-12-08
Abstract	Sepsis is a leading cause of death in intensive care units and is increasing in incidence. Current trials of novel therapeutic approaches for sepsis focus on 28-day mortality as the primary outcome measure, but excess mortality may extend well beyond this time period. We used relative survival analysis to examine excess mortality in a cohort of 1,028 patients admitted to a tertiary referral hospital with sepsis during 2007-2008, over the first 5 years of follow up. Expected survival was estimated using the Ederer II method, using Australian life tables as the reference population. Cumulative and interval specific relative survival were estimated by age group, sex, sepsis severity and Indigenous status. Patients were followed for a median of 4.5 years (range 0-5.2). Of the 1028 patients, the mean age was 46.9 years, 52% were male, 228 (22.2%) had severe sepsis and 218 (21%) died during the follow up period. Mortality based on cumulative relative survival exceeded that of the reference population for the first 2 years post admission in the whole cohort and for the first 3 years in the subgroup with severe sepsis. Independent predictors of mortality over the whole follow up period were male sex, Indigenous Australian ethnicity, older age, higher Charlson Comorbidity Index, and sepsis-related organ dysfunction at presentation. The mortality rate of patients hospitalised with sepsis exceeds that of the general population until 2 years post admission. Efforts to improve outcomes from sepsis should examine longer term outcomes than the traditional primary endpoints of 28-day and 90-day mortality.
Affiliation	Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Australia.. Menzies School of Health Research, Charles Darwin University, Darwin, Australia.. Menzies School of Health Research, Charles Darwin University, Darwin, Australia; Department of Infectious Diseases, Royal Darwin Hospital, Darwin, Australia.. Menzies School of Health Research, Charles Darwin University, Darwin, Australia..
Citation	PloS one 2014; 9(12): e112224
Pubmed ID	https://pubmed.ncbi.nlm.nih.gov/25486241/?otool=iaurydwlib
Link	https://hdl.handle.net/10137/5531
MESH subject	Adult Aged Cohort Studies Comorbidity Female Follow-Up Studies Hospital Mortality Humans Intensive Care Units Male Middle Aged Patient Outcome Assessment Sepsis Survival Analysis Hospitalization
Title	Long term outcomes following hospital admission for sepsis using relative survival analysis: a prospective cohort study of 1,092 patients with 5 year follow up.
Type of document	Journal Article
Entity Type	Publication

Long term outcomes following hospital admission for sepsis using relative survival analysis: a prospective cohort study of 1,092 patients with 5 year follow up.

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