title: Long-Term Outcomes in Critically Ill Septic Patients Who Survived Cardiopulmonary Resuscitation.
abstract: OBJECTIVE
  To evaluate the long-term survival rate of critically ill sepsis survivors following cardiopulmonary resuscitation on a national scale.
  
  
  METHODS
  Retrospective and observational cohort study.
  
  
  METHODS
  Data were extracted from Taiwan's National Health Insurance Research Database.
  
  
  METHODS
  A total of 272,897 ICU patients with sepsis were identified during 2000-2010. Patients who survived to hospital discharge were enrolled. Post-discharge survival outcomes of ICU sepsis survivors who received cardiopulmonary resuscitation were compared with those of patients who did not experience cardiopulmonary arrest using propensity score matching with a 1:1 ratio.
  
  
  METHODS
  None.
  
  
  RESULTS
  Only 7% (n = 3,207) of sepsis patients who received cardiopulmonary resuscitation survived to discharge. The overall 1-, 2-, and 5-year postdischarge survival rates following cardiopulmonary resuscitation were 28%, 23%, and 14%, respectively. Compared with sepsis survivors without cardiopulmonary arrest, sepsis survivors who received cardiopulmonary resuscitation had a greater risk of all-cause mortality after discharge (hazard ratio, 1.38; 95% CI, 1.34-1.46). This difference in mortality risk diminished after 2 years (hazard ratio, 1.11; 95% CI, 0.96-1.28). Multivariable analysis showed that independent risk factors for long-term mortality following cardiopulmonary resuscitation were male sex, older age, receipt of care in a nonmedical center, higher Charlson Comorbidity Index score, chronic kidney disease, cancer, respiratory infection, vasoactive agent use, and receipt of renal replacement therapy during ICU stay.
  
  
  CONCLUSIONS
  The long-term outcome was worse in ICU survivors of sepsis who received in-hospital cardiopulmonary resuscitation than in those who did not, but this increased risk of mortality diminished at 2 years after discharge.
authors.affiliation: 1School of Medicine, Taipei Medical University, Taipei, Taiwan. 2Department of Anesthesiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 3School of Medicine, National Yang-Ming University, Taipei, Taiwan. 4Division of Chest, Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan. 5Division of Nephrology, Department of Medicine, Taipei City Hospital, Heping Fuyou Branch, Taipei, Taiwan. 6National Institute of Infectious Diseases and Vaccinology, National Health Research Institutes, Miaoli County, Taiwan. 7Division of Infectious Diseases, Taipei Veterans General Hospital, Taipei, Taiwan. 8Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan. 9Department of Medicine, Taipei Veterans General Hospital, Yuanshan Branch, Yilan, Taiwan. 10Deran Clinic, Yilan, Taiwan.
authors.forename: Pei-Wen
authors.initials: PW
authors.lastname: Chao
authors.forename: Hsi
authors.initials: H
authors.lastname: Chu
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.forename: Yu-Ning
authors.initials: YN
authors.lastname: Shih
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Shuo-Ming
authors.initials: SM
authors.lastname: Ou
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Shih
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016887:Cardiopulmonary Resuscitation; D015897:Comorbidity; D016638:Critical Illness; D016208:Databases, Factual; D005260:Female; D006323:Heart Arrest / Q000150:complications* / Q000628:therapy; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D018805:Sepsis / Q000150:complications* / Q000401:mortality*; D012737:Sex Factors; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors