OBJECTIVE: The long-term mortality outcome associated with sepsis and septic shock has not been well defined in a nonselected critically ill population. This study investigated the occurrence and the role of bloodstream infection (BSI) associated sepsis and septic shock at time of intensive care unit (ICU) admission on the 1-year mortality of patients admitted to a regional critical care system. DESIGN AND SETTING: Population-based inception cohort in all adult multidisciplinary and cardiovascular ICUs in the Calgary Health Region (population approx. 1 million) between 1 July 1999 and 31 March 2002. PATIENTS AND PARTICIPANTS: Adults (>/=18 years; n=4,845) who had at least one ICU admission to CHR ICUs. RESULTS: In 251 (5%) patients there was BSI-associated sepsis at presentation to ICU, and 159 of these also had septic shock. The 28-day, 90-day, and 1-year mortality rates overall were 18%, 21%, and 24%: 23%, 30%, and 36% for BSI-associated sepsis without shock, and 51%, 57%, and 61% with shock, respectively. Surgical diagnosis, BSI-associated sepsis, and increasing age were independently associated with late (28-day to 1-year) mortality whereas higher APACHE II and TISS scores were associated with reduced odds in logistic regression analysis. CONCLUSIONS: BSI-associated sepsis and septic shock are associated with increased risk of mortality persisting after 28-days up to 1 year or more. Follow-up duration beyond 28 days better defines the burden of illness associated with these syndromes.
OBJECTIVE: The long-term mortality outcome associated with sepsis and septic shock has not been well defined in a nonselected critically ill population. This study investigated the occurrence and the role of bloodstream infection (BSI) associated sepsis and septic shock at time of intensive care unit (ICU) admission on the 1-year mortality of patients admitted to a regional critical care system. DESIGN AND SETTING: Population-based inception cohort in all adult multidisciplinary and cardiovascular ICUs in the Calgary Health Region (population approx. 1 million) between 1 July 1999 and 31 March 2002. PATIENTS AND PARTICIPANTS: Adults (>/=18 years; n=4,845) who had at least one ICU admission to CHR ICUs. RESULTS: In 251 (5%) patients there was BSI-associated sepsis at presentation to ICU, and 159 of these also had septic shock. The 28-day, 90-day, and 1-year mortality rates overall were 18%, 21%, and 24%: 23%, 30%, and 36% for BSI-associated sepsis without shock, and 51%, 57%, and 61% with shock, respectively. Surgical diagnosis, BSI-associated sepsis, and increasing age were independently associated with late (28-day to 1-year) mortality whereas higher APACHE II and TISS scores were associated with reduced odds in logistic regression analysis. CONCLUSIONS:BSI-associated sepsis and septic shock are associated with increased risk of mortality persisting after 28-days up to 1 year or more. Follow-up duration beyond 28 days better defines the burden of illness associated with these syndromes.
Authors: Mitchell M Levy; Mitchell P Fink; John C Marshall; Edward Abraham; Derek Angus; Deborah Cook; Jonathan Cohen; Steven M Opal; Jean-Louis Vincent; Graham Ramsay Journal: Crit Care Med Date: 2003-04 Impact factor: 7.598
Authors: C Brun-Buisson; F Doyon; J Carlet; P Dellamonica; F Gouin; A Lepoutre; J C Mercier; G Offenstadt; B Régnier Journal: JAMA Date: 1995-09-27 Impact factor: 56.272
Authors: Remco P H Peters; Paul H M Savelkoul; Alberdina M Simoons-Smit; Sven A Danner; Christina M J E Vandenbroucke-Grauls; Michiel A van Agtmael Journal: J Clin Microbiol Date: 2006-01 Impact factor: 5.948
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Authors: Manu Shankar-Hari; Gary S Phillips; Mitchell L Levy; Christopher W Seymour; Vincent X Liu; Clifford S Deutschman; Derek C Angus; Gordon D Rubenfeld; Mervyn Singer Journal: JAMA Date: 2016-02-23 Impact factor: 56.272
Authors: Nicolas Nesseler; Anne Defontaine; Yoann Launey; Jeff Morcet; Yannick Mallédant; Philippe Seguin Journal: Intensive Care Med Date: 2013-01-29 Impact factor: 17.440
Authors: Sebastián Iribarren-Diarasarri; Felipe Aizpuru-Barandiaran; Tomás Muñoz-Martínez; Angel Loma-Osorio; Marianela Hernández-López; José María Ruiz-Zorrilla; Carlos Castillo-Arenal; Juan Luis Dudagoitia-Otaolea; Sergio Martínez-Alutiz; Cristina Vinuesa-Lozano Journal: Intensive Care Med Date: 2009-01-29 Impact factor: 17.440