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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

1
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.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

PMID:
23689053
PMCID:
PMC4047671
DOI:
10.1097/MAJ.0b013e318295a147
[Indexed for MEDLINE]
Free PMC Article

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