Shuo-Ming Ou1,2,3, Hsi Chu2,4, Pei-Wen Chao5,6, Yi-Jung Lee2,7, Shu-Chen Kuo8,2,9, Tzeng-Ji Chen10, Ching-Min Tseng2,11, Chia-Jen Shih2,12,13, Yung-Tai Chen2,14. 1. 1 Division of Nephrology, Department of Medicine. 2. 2 School of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. 3 Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 4. 4 Department of Chest, and. 5. 5 College of Medicine and. 6. 6 Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 7. 7 Department of Neurology, Taipei City Hospital, Ren Ai Branch, Taipei, Taiwan. 8. 9 Division of Infectious Diseases, and. 9. 8 National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan. 10. 10 Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 11. 11 Division of Respiratory Therapy, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan. 12. 12 Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan; and. 13. 13 Deran Clinic, Yilan, Taiwan. 14. 14 Division of Nephrology, Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan.
Abstract
RATIONALE: Patients with sepsis who survive to hospital discharge may present with ongoing high morbidity and mortality. However, little is known about the risk of long-term, all-cause mortality and cardiovascular outcomes after sepsis. OBJECTIVES: Our study aimed to investigate the long-term clinical outcomes in sepsis survivors. METHODS: In this nationwide population-based study, data from patients with sepsis were retrieved from Taiwan's National Health Insurance Research Database between 2000 and 2002. Each sepsis survivor was 1:1 propensity-matched to control subjects from two different control populations: subjects who were in the general population and subjects who were hospitalized for a nonsepsis diagnosis. The primary outcomes were all-cause mortality, major adverse cardiovascular events, myocardial infarction, heart failure, stroke, and sudden cardiac death or ventricular arrhythmia. MEASUREMENTS AND MAIN RESULTS: Compared with matched population control subjects, sepsis survivors had higher risks of all-cause mortality (hazard ratio [HR], 2.18; 95% confidence interval [CI], 2.14-2.22), major adverse cardiovascular events (HR, 1.37; 95% CI, 1.34-1.41), ischemic stroke (HR, 1.27; 95% CI, 1.23-1.32), hemorrhagic stroke (HR, 1.36; 95% CI, 1.26-1.46), myocardial infarction (HR, 1.22; 95% CI, 1.14-1.30), heart failure (HR, 1.48; 95% CI, 1.43-1.53), and sudden cardiac death or ventricular arrhythmia (HR, 1.65; 95% CI, 1.57-1.74). Similar results, although slightly attenuated risks, were found when comparisons were made with hospitalized control subjects without sepsis. CONCLUSIONS: These data indicate that sepsis survivors had substantially increased risks of subsequent all-cause mortality and major adverse cardiovascular events at 1 year after discharge, which persisted for up to 5 years after discharge.
RATIONALE: Patients with sepsis who survive to hospital discharge may present with ongoing high morbidity and mortality. However, little is known about the risk of long-term, all-cause mortality and cardiovascular outcomes after sepsis. OBJECTIVES: Our study aimed to investigate the long-term clinical outcomes in sepsis survivors. METHODS: In this nationwide population-based study, data from patients with sepsis were retrieved from Taiwan's National Health Insurance Research Database between 2000 and 2002. Each sepsis survivor was 1:1 propensity-matched to control subjects from two different control populations: subjects who were in the general population and subjects who were hospitalized for a nonsepsis diagnosis. The primary outcomes were all-cause mortality, major adverse cardiovascular events, myocardial infarction, heart failure, stroke, and sudden cardiac death or ventricular arrhythmia. MEASUREMENTS AND MAIN RESULTS: Compared with matched population control subjects, sepsis survivors had higher risks of all-cause mortality (hazard ratio [HR], 2.18; 95% confidence interval [CI], 2.14-2.22), major adverse cardiovascular events (HR, 1.37; 95% CI, 1.34-1.41), ischemic stroke (HR, 1.27; 95% CI, 1.23-1.32), hemorrhagic stroke (HR, 1.36; 95% CI, 1.26-1.46), myocardial infarction (HR, 1.22; 95% CI, 1.14-1.30), heart failure (HR, 1.48; 95% CI, 1.43-1.53), and sudden cardiac death or ventricular arrhythmia (HR, 1.65; 95% CI, 1.57-1.74). Similar results, although slightly attenuated risks, were found when comparisons were made with hospitalized control subjects without sepsis. CONCLUSIONS: These data indicate that sepsis survivors had substantially increased risks of subsequent all-cause mortality and major adverse cardiovascular events at 1 year after discharge, which persisted for up to 5 years after discharge.
Entities:
Keywords:
epidemiology; heart failure; major adverse cardiovascular events; mortality; sepsis
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