Risk of out-of-hospital cardiac arrest among sepsis survivors in Taiwan: analysis of a nationwide population-based cohort.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
14 09 2021
Historique:
entrez: 15 9 2021
pubmed: 16 9 2021
medline: 3 11 2021
Statut: epublish

Résumé

There is minimal literature examining the association of sepsis with out-of-hospital cardiac arrest (OHCA). Using a large national database, we aimed to quantify the risk of OHCA among sepsis patients after hospital discharge. Population-based cohort study. Nationwide sepsis cohort retrieved from the National Health Insurance Research Database of Taiwan between 2000 and 2013. We included 17 304 patients with sepsis. After hospital discharge, 144 patients developed OHCA within 30 days and 640 between days 31 and 365. The main outcomes were OHCA events following hospital discharge for sepsis. To evaluate the independent association between sepsis and OHCA after a sepsis hospitalisation, we constructed two non-sepsis comparison cohorts using risk set sampling and propensity score matching techniques (non-infection cohort, non-sepsis infection cohort). We plotted the daily number and daily risk of OHCA within 1 year of hospital discharge between sepsis and matched non-sepsis cohorts. We used Cox regression to evaluate the risk of early and late OHCA, comparing sepsis to non-sepsis patients. Compared with non-infected patients, sepsis patients had a higher rate of early (HR 1.66, 95% CI: 1.27 to 2.16) and late (HR 1.19, 95% CI: 1.06 to 1.33) OHCA events. This association was independent of age, sex or cardiovascular history. Compared with non-sepsis patients with infections, sepsis patients had a higher rate of both early (HR 1.28, 95% CI: 1.00 to 1.63) and late (HR 1.13, 95% CI: 1.01 to 1.27) OHCA events, especially among patients with cardiovascular disease (OR 1.35, 95% CI: 1.01 to 1.81). Sepsis patients had increased risk of OHCA compared with matched non-sepsis controls, which lasted up to 1 year after hospital discharge.

Identifiants

pubmed: 34521676
pii: bmjopen-2021-051502
doi: 10.1136/bmjopen-2021-051502
pmc: PMC8442105
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e051502

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Wan-Ting Hsu (WT)

Department of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA.

Charles Fox Sherrod (CF)

Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Babak Tehrani (B)

Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Alexa Papaila (A)

Department of Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.

Lorenzo Porta (L)

Department of Emergency Medicine, Università degli Studi di Milano-Bicocca, Milano, Italy.

Tzu-Chun Hsu (TC)

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Wang-Huei Sheng (WH)

Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.

Chien-Chang Lee (CC)

Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan cclee100@gmail.com.
The Centre for Intelligent Healthcare, National Taiwan University Hospital, Taipei, Taiwan.
Byers Center for Biodesign, School of Medicine, Stanford University, Palo Alto, CA, USA.

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