Lina De Geer1,2, Anna Oscarsson Tibblin1,2, Mats Fredrikson3, Sten M Walther2,4. 1. Department of Anaesthesiology and Intensive Care, Linköping University, Linköping, Sweden. 2. Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 3. Division of Occupational and Environmental Medicine, Department of Clinical and Experimental Medicine and Forum Östergötland, Linköping University, Linköping, Sweden. 4. Department of Thoracic and Vascular Surgery, Linköping University, Linköping, Sweden.
Abstract
BACKGROUND: Cardiac dysfunction is a well-known complication of sepsis, but its long-term consequences and implications for patients remain unclear. The aim of this study was to investigate cardiac outcome in sepsis by assessing causes of death up to 2 years after treatment in an Intensive Care Unit (ICU) in a nationwide register-based cohort collected from the Swedish Intensive Care Registry. METHODS: A cohort of 13 669 sepsis and septic shock ICU patients from 2008 to 2014 was collected together with a non-septic control group, matched regarding age, sex and severity of illness (n = 6582), and all without preceding severe cardiac disease. For a large proportion of the severe sepsis and septic shock patients (n = 7087), no matches were found. Information on causes of death up to 2 years after ICU admission was sought in the Swedish National Board of Health and Welfare's Cause of Death Registry. RESULTS: Intensive Care Unit mortality was nearly identical in a matched comparison of sepsis patients to controls (24% in both groups) but higher in more severely ill sepsis patients for whom no matches were found (33% vs 24%, P < 0.001). There was no association of sepsis to cardiac deaths in the first month (OR 1.03, 95%CI 0.87 to 1.20, P = 0.76) nor up to 2 years after ICU admission (OR 1.01, 95%CI 0.82 to 1.25, P = 0.94) in an adjusted between-group comparison. CONCLUSIONS: There was no association with an increased risk of death related to cardiac disease in patients with severe sepsis or septic shock when compared to other ICU patients with similar severity of illness.
BACKGROUND:Cardiac dysfunction is a well-known complication of sepsis, but its long-term consequences and implications for patients remain unclear. The aim of this study was to investigate cardiac outcome in sepsis by assessing causes of death up to 2 years after treatment in an Intensive Care Unit (ICU) in a nationwide register-based cohort collected from the Swedish Intensive Care Registry. METHODS: A cohort of 13 669 sepsis and septic shock ICUpatients from 2008 to 2014 was collected together with a non-septic control group, matched regarding age, sex and severity of illness (n = 6582), and all without preceding severe cardiac disease. For a large proportion of the severe sepsis and septic shockpatients (n = 7087), no matches were found. Information on causes of death up to 2 years after ICU admission was sought in the Swedish National Board of Health and Welfare's Cause of Death Registry. RESULTS: Intensive Care Unit mortality was nearly identical in a matched comparison of sepsispatients to controls (24% in both groups) but higher in more severely ill sepsispatients for whom no matches were found (33% vs 24%, P < 0.001). There was no association of sepsis to cardiac deaths in the first month (OR 1.03, 95%CI 0.87 to 1.20, P = 0.76) nor up to 2 years after ICU admission (OR 1.01, 95%CI 0.82 to 1.25, P = 0.94) in an adjusted between-group comparison. CONCLUSIONS: There was no association with an increased risk of death related to cardiac disease in patients with severe sepsis or septic shock when compared to other ICU patients with similar severity of illness.
Authors: Leah B Kosyakovsky; Federico Angriman; Emma Katz; Neill K Adhikari; Lucas C Godoy; John C Marshall; Bruno L Ferreyro; Douglas S Lee; Robert S Rosenson; Naveed Sattar; Subodh Verma; Augustin Toma; Marina Englesakis; Barry Burstein; Michael E Farkouh; Margaret Herridge; Dennis T Ko; Damon C Scales; Michael E Detsky; Lior Bibas; Patrick R Lawler Journal: Intensive Care Med Date: 2021-08-09 Impact factor: 17.440
Authors: Kristoffer Strålin; Erik Wahlström; Sten Walther; Anna M Bennet-Bark; Mona Heurgren; Thomas Lindén; Johanna Holm; Håkan Hanberger Journal: Lancet Reg Health Eur Date: 2021-02-26