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Late mortality after sepsis: propensity matched cohort study.

Prescott HC, Osterholzer JJ, Langa KM, Angus DC, Iwashyna TJ. Late mortality after sepsis: propensity matched cohort study. BMJ (Clinical research ed.). 2016 May 17; 353:i2375.

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OBJECTIVES:  To determine whether late mortality after sepsis is driven predominantly by pre-existing comorbid disease or is the result of sepsis itself. DEIGN:  Observational cohort study. SETTING:  US Health and Retirement Study. PARTICIPANTS:  960 patients aged = 65 (1998-2010) with fee-for-service Medicare coverage who were admitted to hospital with sepsis. Patients were matched to 777 adults not currently in hospital, 788 patients admitted with non-sepsis infection, and 504 patients admitted with acute sterile inflammatory conditions. MAIN OUTCOME MEASURES:  Late (31 days to two years) mortality and odds of death at various intervals. RESULTS:  Sepsis was associated with a 22.1% (95% confidence interval 17.5% to 26.7%) absolute increase in late mortality relative to adults not in hospital, a 10.4% (5.4% to 15.4%) absolute increase relative to patients admitted with non-sepsis infection, and a 16.2% (10.2% to 22.2%) absolute increase relative to patients admitted with sterile inflammatory conditions (P < 0.001 for each comparison). Mortality remained higher for at least two years relative to adults not in hospital. CONCLUSIONS:  More than one in five patients who survives sepsis has a late death not explained by health status before sepsis.

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