Konrad Schmidt1, Jochen Gensichen, Carolin Fleischmann-Struzek, Viola Bahr, Christine Pausch, Yasser Sakr, Konrad Reinhart, Horst Christian Vollmar, Paul Thiel, André Scherag, Julia Gantner, Frank M Brunkhorst. 1. Center for Sepsis Control and Care (CSCC), Jena University Hospital; Institute of General Practice and Family Medicine, Jena University Hospital; Institute of General Practice, Charité-Universitätsmedizin Berlin; Institute of General Practice and Family Medicine, Munich University Hospital, Ludwig-Maximilians-Universität München; Center for Clinical Studies, Jena University Hospital; Clinic for Anaesthesiology and Intensive Care Medicine, Jena University Hospital; Institute for Medical Informatics, Statistics and Epidemiology (IMISE), Leipzig University; Institute of General Practice and Family Medicine, Ruhr-University Bochum; Institute of Medical Statistics, Computer Science and Data Sciences, Jena University Hospital.
Abstract
BACKGROUND: There have not yet been any prospective registry studies in Germany with active investigation of the long-term survival of patients with sepsis. METHODS: The Jena Sepsis Registry (JSR) included all patients with a diagnosis of sepsis in the four intensive care units of Jena University Hospital from January 2011 to December 2015. Long-term survival 6-48 months after diagnosis was documented by asking the treating general practitioners. The survival times were studied with Kaplan-Meier estimators. Cox regressions were calculated to show associations between possible predictors and survival time. RESULTS: 1975 patients with sepsis or septic shock were included. The mean time of observation was 730 days. For 96.4% of the queries to the general practitioners, information on long-term survival was available. Mortality in the intensive care unit was 34% (95% confidence interval [32; 37]), and in-hospital mortality was 45% [42; 47]. The overall mortality six months after diagnosis was 59% [57; 62], the overall mortality 48 months after diagnosis was 74% [72; 78]. Predictors of shorter survival were age, nosocomial origin of sepsis, diabetes, cerebrovascular disease, duration of stay in the intensive care unit, and renal replacement therapy. CONCLUSION: The nearly 75% mortality four years after diagnosis indicates that changes are needed both in the acute treatment of patients with sepsis and in their multi-sector long-term care. The applicability of these findings may be limited by their having been obtained in a single center.
BACKGROUND: There have not yet been any prospective registry studies in Germany with active investigation of the long-term survival of patients with sepsis. METHODS: The Jena Sepsis Registry (JSR) included all patients with a diagnosis of sepsis in the four intensive care units of Jena University Hospital from January 2011 to December 2015. Long-term survival 6-48 months after diagnosis was documented by asking the treating general practitioners. The survival times were studied with Kaplan-Meier estimators. Cox regressions were calculated to show associations between possible predictors and survival time. RESULTS: 1975 patients with sepsis or septic shock were included. The mean time of observation was 730 days. For 96.4% of the queries to the general practitioners, information on long-term survival was available. Mortality in the intensive care unit was 34% (95% confidence interval [32; 37]), and in-hospital mortality was 45% [42; 47]. The overall mortality six months after diagnosis was 59% [57; 62], the overall mortality 48 months after diagnosis was 74% [72; 78]. Predictors of shorter survival were age, nosocomial origin of sepsis, diabetes, cerebrovascular disease, duration of stay in the intensive care unit, and renal replacement therapy. CONCLUSION: The nearly 75% mortality four years after diagnosis indicates that changes are needed both in the acute treatment of patients with sepsis and in their multi-sector long-term care. The applicability of these findings may be limited by their having been obtained in a single center.
Authors: Johannes Roth; Oliver Sommerfeld; Andreas L Birkenfeld; Christoph Sponholz; Ulrich A Müller; Christian von Loeffelholz Journal: Dtsch Arztebl Int Date: 2021-09-17 Impact factor: 5.594
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