Postdischarge Survival After Sepsis: A Cohort Study
Authors' conclusion
Acute physiologic derangements and organ dysfunction were associated with postdischarge mortality with the associations decreasing over time.
Study context
- Population
- Hospital survivors of sepsissurvived sepsis at discharge
- Participants
- 32,244 survivors
- Outcome
- Postdischarge mortality and associated factors, and how they vary with time after discharge
Methodological detailstime-varying Cox proportional hazard models
- Time-varying Cox proportional hazard models
Main finding
As reported in the abstract
Postdischarge mortality and survival
- Died after discharge
- 13,565 (42%)
- Time to death after discharge, mean ± SD
- 1.41 ± 1.87 years
- Still alive at follow-up
- 18,679
- Follow-up of survivors, mean ± SD
- 4.98 ± 2.86 years
- Died during first month after discharge
- 8.7%
- Died during 12th month after discharge
- 1.1%
- Died during 60th month after discharge
- 0.3%
- Kaplan-Meier survival at 1 month
- 91% (95% CI, 91%-92%)
- Kaplan-Meier survival at 1 year
- 76% (95% CI, 76%-77%)
- Kaplan-Meier survival at 5 years
- 57% (95% CI, 56%-58%)
- Kaplan-Meier survival at 10 years
- 48% (95% CI, 47%-48%)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Elevated urea nitrogen at discharge and mortalityUrea nitrogen (per 10 mg/dL) | HR 1.10 (95% CI 1.08–1.12) | P < 0.001 | |
| Elevated urea nitrogen at discharge and mortalityUrea nitrogen (per 10 mg/dL per year) · HR decreased with time from discharge | δHR 0.98 (95% CI 0.98–0.99) | P < 0.001 | |
| Hemoglobin and mortalityHemoglobin (per g/dL) | HR 0.92 (95% CI 0.91–0.93) | P < 0.001 | |
| Hemoglobin and mortalityHemoglobin (per g/dL per year) | δHR 1.02 (95% CI 1.01–1.02) | P < 0.001 | |
| Older age and mortalityAge (per decade) | HR 1.29 (95% CI 1.27–1.31) | P < 0.001 | |
| Older age and mortalityAge (per year of follow-up per decade of age) · risk grew with time after discharge | δHR 1.01 (95% CI 1.00–1.02) | P < 0.001 | |
| Insurance status and mortalityMedicaid vs Private insurance · did not change with time after discharge | HR 1.17 (95% CI 1.10–1.25) | P < 0.001 | |
| Insurance status and mortalityMedicare (per year of follow-up) vs Private insurance · greater risk as time after discharge increased | δHR 1.04 (95% CI 1.03–1.05) | P < 0.001 | |
| 0.512Ratio (log scale) |
| Outcome | HR |
|---|---|
| Insurance status and mortalityMedicare vs Private insurance · at discharge | 1 |
Original publication
Postdischarge Survival After Sepsis: A Cohort Study. Anesth Analg. Published 18 October 2023. doi:10.
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