Magnitude and duration of the effect of sepsis on survival. Department of Veterans Affairs Systemic Sepsis Cooperative Studies Group.
OBJECTIVE
To determine the magnitude and duration of the effects of sepsis on survival.


METHODS
Cohort study.


METHODS
The 10 Department of Veterans Affairs Medical Centers of the Systemic Sepsis Cooperative Studies Group, which from 1983 to 1986 conducted the Department of Veterans Affairs Cooperative Study of Corticosteroids in Systemic Sepsis.


METHODS
The septic population consisted of 1505 patients with evaluable data from the screening log of the Cooperative Study of Corticosteroids in Systemic Sepsis. All 91830 nonpsychiatric, noninfected patients discharged from the participating medical centers between October 1, 1984, and September 30, 1985, were included in the control population.


METHODS
Death through 8 years after the index hospitalization.


RESULTS
On the basis of a proportional hazards model constructed from the demographic and illness characteristics of the control population, the septic population was at significant risk of dying of nonseptic causes (26% predicted 1-year mortality). In the septic population, the daily risk of dying exceeded predictions from this model for 5 years, and the hazard rate rose with increasing severity of the septic episode throughout the first year (P<.05). Among 30-day survivors, sepsis reduced the remaining mean life span from a predicted 8.03 years to 4.08 years.


CONCLUSIONS
Sepsis not only causes deaths acutely, but also increases the risk of death for up to 5 years after the septic episode even after comorbidities are accounted for. The risk of late death during the first year is associated with the severity of the septic episode.
Quartin
A A
AA
Miami Veterans Affairs Medical Center and the Division of Pulmonary and Critical Care Medicine, University of Miami, FL 33125, USA.
Schein
R M
RM
Kett
D H
DH
Peduzzi
P N
PN
D000368:Aged; D002423:Cause of Death; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D018805:Sepsis / Q000401:mortality*; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs