title: Short- and long-term mortality in patients with community-acquired severe sepsis and septic shock.
abstract: BACKGROUND
  Severe sepsis and septic shock have a high 30-day mortality (10-50%), but the long-term mortality is not well described. The purpose of this study was to describe long-term mortality among patients with community-acquired severe sepsis or septic shock compared to a population-based reference cohort.
  
  
  METHODS
  Two hundred and twelve patients who, within the first 24 h after arrival at the hospital, presented with infection and had failure of at least 1 organ system were included. A population-based reference group of 79,857 patients was identified, and data on comorbidities were extracted from the National Danish Patient Registry. We analyzed the hazard ratio for mortality at predefined intervals.
  
  
  RESULTS
  Absolute mortality within the first 30 days was 69/211 (33%, 95% confidence interval (CI) 25-41%), with a cumulative mortality of 121/211 (57%, 95% CI 48-69%) for the entire follow-up. Among septic patients who survived the first 30 days, the mortality hazard ratio was 2.7 (95% CI 1.7-4.3) until day 365, and among septic patients who survived the first year, the 1-4 y mortality hazard ratio was 2.3 (95% CI 1.7-3.3), compared to the community-based reference persons (multivariate Cox regression controlling for age, sex, and Charlson comorbidity index).
  
  
  CONCLUSIONS
  Patients with severe sepsis and septic shock who survived the first 30 days had a 2.7 times higher mortality hazard in the first year and a 2.3 times higher mortality hazard in the next 3 y, compared to persons of similar age, sex, and comorbidity level.
authors.affiliation: Department of Infectious Diseases, University Hospital Aarhus, Denmark. merestor@rm.dk
authors.forename: Merete
authors.initials: M
authors.lastname: Storgaard
authors.forename: Jesper
authors.initials: J
authors.lastname: Hallas
authors.forename: Bente
authors.initials: B
authors.lastname: Gahrn-Hansen
authors.forename: Svend S
authors.initials: SS
authors.lastname: Pedersen
authors.forename: Court
authors.initials: C
authors.lastname: Pedersen
authors.forename: Annmarie T
authors.initials: AT
authors.lastname: Lassen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000401:mortality*; D016019:Survival Analysis; D055815:Young Adult