Shuo-Ming Ou, Hsi Chu, Pei-Wen Chao, Yi-Jung Lee, Shu-Chen Kuo, Tzeng-Ji Chen, Ching-Min Tseng, Chia-Jen Shih, and Yung-Tai Chen  Am. J. Resp. Crit. Care Med. Jul 15. 2016, vol. 194, no. 2: 209-217

Rationale: Patients with sepsis who survive to hospital discharge may present with ongoing high morbidity and mortality. However, little is known about the risk of long-term, all-cause mortality and cardiovascular outcomes after sepsis.

Objectives: Our study aimed to investigate the long-term clinical outcomes in sepsis survivors.

Methods: In this nationwide population-based study, data from patients with sepsis were retrieved from Taiwan’s National Health Insurance Research Database between 2000 and 2002. Each sepsis survivor was 1:1 propensity-matched to control subjects from two different control populations: subjects who were in the general population and subjects who were hospitalized for a nonsepsis diagnosis. The primary outcomes were all-cause mortality, major adverse cardiovascular events, myocardial infarction, heart failure, stroke, and sudden cardiac death or ventricular arrhythmia.

Measurements and Main Results: Compared with matched population control subjects, sepsis survivors had higher risks of all-cause mortality (hazard ratio [HR], 2.18; 95% confidence interval [CI], 2.14–2.22), major adverse cardiovascular events (HR, 1.37; 95% CI, 1.34–1.41), ischemic stroke (HR, 1.27; 95% CI, 1.23–1.32), hemorrhagic stroke (HR, 1.36; 95% CI, 1.26–1.46), myocardial infarction (HR, 1.22; 95% CI, 1.14–1.30), heart failure (HR, 1.48; 95% CI, 1.43–1.53), and sudden cardiac death or ventricular arrhythmia (HR, 1.65; 95% CI, 1.57–1.74). Similar results, although slightly attenuated risks, were found when comparisons were made with hospitalized control subjects without sepsis.

Conclusions: These data indicate that sepsis survivors had substantially increased risks of subsequent all-cause mortality and major adverse cardiovascular events at 1 year after discharge, which persisted for up to 5 years after discharge.

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