Long-Term Survival Following Sepsis.


Journal

Deutsches Arzteblatt international
ISSN: 1866-0452
Titre abrégé: Dtsch Arztebl Int
Pays: Germany
ID NLM: 101475967

Informations de publication

Date de publication:
13 11 2020
Historique:
received: 07 04 2020
revised: 07 04 2020
accepted: 24 06 2020
entrez: 3 2 2021
pubmed: 4 2 2021
medline: 23 2 2021
Statut: ppublish

Résumé

There have not yet been any prospective registry studies in Germany with active investigation of the long-term survival of patients with sepsis. 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. 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. 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.

Sections du résumé

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.

Identifiants

pubmed: 33533711
pii: arztebl.2020.0775
doi: 10.3238/arztebl.2020.0775
pmc: PMC7930463
doi:
pii:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

775-782

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Auteurs

Konrad Schmidt (K)

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.

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