Clinical InvestigationPredictors of Long-term Mortality After Severe Sepsis in the Elderly
Section snippets
METHODS
Our study used data from the administrative databases of the Department of VA health care systems. The data were a collection of clinical data from all of the VA hospitals and outpatient clinics. The institutional Review Board of the University of Texas Health Science Center at San Antonio approved this study under expedited review. Waiver of informed consent was obtained for this study.
Patient Characteristics
A total of 2,727 patients met the criteria to be included in this study. We identified 7,302 hospitalizations due to severe sepsis that received antibiotic treatment within the 1st 48 hours of admission (Figure 1). Of those, we excluded the 4,411 patients who died within 90 days of hospital admission and 164 episodes that were rehospitalizations. Of those who meet the inclusion criteria, 1,501 (55%) died during the follow-up period. Our cohort was largely men (98.5%), with an average age of 76
DISCUSSION
Sepsis is a disease of great importance to clinicians, but long-term effects of a severe sepsis diagnosis have been studied only superficially. This study builds on the small number of prior papers that examined the long-term effects of severe sepsis and found associations between long-term mortality and factors such as age, multiple comorbid conditions, mechanical ventilation, medication use and smoking cessation. This study is important because it highlights the long-term effects of severe
CONCLUSIONS
In conclusion, there is substantial long-term mortality after severe sepsis and care should not end after discharge from the hospital, especially for patients with the risk factors for long-term mortality. Clinicians should closely monitor those who survive the initial hospitalization for severe sepsis so as to identify factors that may be potentially modifiable. In addition, this information should be provided to patients and their families so as to help them understand the natural history of
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This study was supported by the National Institute of Nursing Research Grant R01NR010828.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Nursing Research or the National Institutes of Health. This material is the result of work supported with resources and the use of facilities at the South Texas Veterans Health Care System. Funding agencies had no role in conducting the study or role in the preparation, review or approval of the manuscript. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs.
The authors have no financial or other conflicts of interest to disclose.