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Am J Med Sci. 2014 Apr;347(4):282-8. doi: 10.1097/MAJ.0b013e318295a147.

Predictors of long-term mortality after severe sepsis in the elderly.

Author information

VERDICT research program, and South Texas Veterans Health Care System, Audie L. Murphy Division (MIR, EMM), University of Texas Health Science Center at San Antonio, San Antonio, Texas; and Divisions of Hospital Medicine (ACL, EMM) and Pulmonary/Critical Care Medicine (MIR, AA), Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas.



Mortality rates after severe sepsis are extremely high, and the main focus of most research is short-term mortality, which may not be associated with long-term outcomes. The purpose of this study was to examine long-term mortality after a severe sepsis and identify factors associated with this mortality.


The authors performed a population-based study using Veterans' Affairs administrative data of patients aged 65 years and older. The outcome of interest was mortality > 90 days following hospitalization. Our primary analyses were Cox proportional hazard models to examine specific risk factors for long-term mortality.


There were 2,727 patients that met the inclusion criteria. Overall mortality was 55%, and 1- and 2-year mortality rates were 31% and 43%, respectively. Factors significantly associated with long-term mortality included congestive heart failure, peripheral vascular disease, dementia, diabetes with complications and use of mechanical ventilation. Smoking cessation and cardiac medications were associated with decreased long-term mortality rates.


The authors identified several factors, including receipt of mechanical ventilation, which were significantly associated with increased long-term mortality for survivors of severe sepsis. This information will help clinicians discuss prognosis with patients and their families.

[Indexed for MEDLINE]
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