Long-term mortality after community-acquired sepsis: a longitudinal population-based cohort study.
OBJECTIVE
Prior studies have concentrated on the acute short-term outcomes of sepsis, with little focus on its long-term consequences. The objective of this study was to characterise long-term mortality following a sepsis event.


METHODS
Population-based data from the 30 239 community-dwelling individuals in the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort.


METHODS
Community-dwelling adults ≥45 years of age. Sepsis was defined as hospitalisation or emergency department treatment for a serious infection with the presence of ≥2 systemic inflammatory response syndrome criteria.


RESULTS
6-year all-cause mortality. The analysis utilised a time-varying Cox model adjusted for participant's age, demographic factors, health behaviours and chronic medical conditions.


RESULTS
The participants were observed for a median of 6.1 years (IQR 4.5-7.1). During this period, 975 individuals experienced a sepsis event. Sepsis hospital mortality was 8.9%. One-year, 2-year and 5-year all-cause mortality among individuals with sepsis were 23%, 28.8% and 43.8%, respectively, compared with death rates of 1%, 2.6% and 8.3% among those who never developed sepsis. On multivariable analysis, the association of sepsis with increased all-cause mortality persisted for up to 5 years, after adjustment for confounders; year 0.00-1.00, adjusted HR (aHR) 13.07 (95% CI 10.63 to 16.06); year 1.01-2.00 aHR 2.64 (1.85 to 3.77); year 2.01-3.00 aHR 2.18 (1.43 to 3.33); year 3.01-4.00 aHR 1.97 (1.19 to 3.25); year 4.01-5.00 aHR 2.08 (1.14 to 3.79); year 5.01+ aHR 1.41 (0.67 to 2.98).


CONCLUSIONS
Individuals with sepsis exhibited increased rates of death for up to 5 years after the illness event, even after accounting for comorbidities. Sepsis is independently associated with increased risk of mortality well after hospital treatment.
Department of Emergency Medicine, University of Alabama School of Medicine, Birmingham, Alabama, USA.
Henry E
HE
Wang
Jeff M
JM
Szychowski
Russell
R
Griffin
Monika M
MM
Safford
Nathan I
NI
Shapiro
George
G
Howard
D000368:Aged; D017714:Community-Acquired Infections / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology; D015897:Comorbidity; D003710:Demography; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D018805:Sepsis / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000523:psychology; D012720:Severity of Illness Index; D013995:Time; D014481:United States / Q000453:epidemiology
Epidemiology; Infectious Diseases