title: Long-term (10-year) mortality of younger previously healthy patients with severe sepsis/septic shock is worse than that of patients with nonseptic critical illness and of the general population.
abstract: OBJECTIVE
  Long-term (1- to 10-year) outcomes after severe sepsis in previously healthy persons are unknown. We aimed to determine the 1- to 10-year mortality rates of previously healthy patients with severe sepsis and compare these to mortality rates of patients with nonseptic critical illness and the general population.
  
  
  METHODS
  A prospective cohort study of 2,289 patients from one mixed medical-surgical ICU and one cardiovascular surgery ICU. Age- and gender-comparable general British Columbia population was used as comparison. Patients were followed from the date of admission to the ICU to January 31, 2013. Provincial vital statistics were used to determine the patients' date of death. For the general population comparison, expected survival was obtained from life tables of the population of British Columbia, Canada.
  
  
  METHODS
  A quaternary-level provincial referral hospital in Vancouver, British Columbia, Canada.
  
  
  METHODS
  Two thousand two hundred eighty-nine patients from one mixed medical-surgical ICU and one cardiovascular surgery ICU. Age- and gender-comparable general British Columbia population was used for comparison.
  
  
  METHODS
  None.
  
  
  RESULTS
  Patients with severe sepsis without comorbidities had higher mortality from 1 to 10 years than general British Columbia population (p < 0.01). Younger patients with severe sepsis (< 60 yr) had the worst 1- to 5-year and 5- to 10-year mortality (hazard ratio [95% CI], 17.8 [13.4-24.8] and 6.0 [4-9]) compared with the general population. Patients with severe sepsis had significantly poorer 1- to 10-year mortality rates (30.5%) compared with patients with nonseptic critical illness (22.1%) and patients who have undergone cardiovascular surgery (15.9%). Patients with sepsis had higher mortality rates from 1-5 years and 5-10 years than the general British Columbia population (hazard ratio [95% CI], 4.5 [2.2-9.1] and 2.2 [0.9-14.7]).
  
  
  CONCLUSIONS
  Previously healthy patients suffering an episode of severe sepsis have increased long-term mortality compared with patients with nonseptic critical illness and a general population.
authors: 1Centre for Heart Lung Innovation, Division of Critical Care Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada. 2Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden. 3Centre for Health Evaluation and Outcome Sciences, University of British Columbia, Vancouver, BC, Canada. 4School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
authors: Adam
authors: A
authors: Linder
authors: Daphne
authors: D
authors: Guh
authors: John H
authors: JH
authors: Boyd
authors: Keith R
authors: KR
authors: Walley
authors: Aslam H
authors: AH
authors: Anis
authors: James A
authors: JA
authors: Russell
mesh_terms: D000367:Age Factors; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D016022:Case-Control Studies; D016638:Critical Illness / Q000401:mortality*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D011446:Prospective Studies; D018805:Sepsis / Q000401:mortality*; D012772:Shock, Septic / Q000401:mortality*