Short-term organ dysfunction is associated with long-term (10-Yr) mortality of septic shock

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Linder, AdamLund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine (author)

Short-term organ dysfunction is associated with long-term (10-Yr) mortality of septic shock

Article/chapterEnglish2016

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2016

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LIBRIS-ID:oai:lup.lub.lu.se:4a54584f-6444-406f-874b-ca972dd35f5d
https://lup.lub.lu.se/record/4a54584f-6444-406f-874b-ca972dd35f5dURI
https://doi.org/10.1097/CCM.0000000000001843DOI

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Language:English
Summary in:English

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Objectives: As mortality of septic shock decreases, new therapies focus on improving short-term organ dysfunction. However, it is not known whether short-term organ dysfunction is associated with long-term mortality of septic shock. Design: Retrospective single-center. Setting: Mixed medical-surgical ICU. Patients: One thousand three hundred and thirty-one patients with septic shock were included from 2000-2004. To remove the bias of 28-day nonsurvivors' obvious association with long-term mortality, we determined the associations of days alive and free of ventilation, vasopressors and renal replacement therapy in 28-day and 1-year survivors with 1-, 5- and 10-year mortality in unadjusted analyses and analyses adjusted for age, gender, Acute Physiology and Chronic Health Evaluation II and presence of chronic comorbidities. Interventions: None. Measurements and Main Results: Days alive and free of ventilation, vasopressors, and renal replacement therapy were highly significantly associated with 1-, 5-, and 10-year mortality (p <0.0001). In 28-day survivors, using Bonferroni-corrected multiple logistic regression, days alive and free of ventilation (p <0.0001, p = 0.0002, and p = 0.001), vasopressors (p <0.0001, p <0.0001, and p = 0.0004), and renal replacement therapy (p = 0.0008, p = 0.0008, and p = 0.0002) were associated with increased 1-, 5-, and 10-year mortality, respectively. In 1-year survivors, none of the acute organ support and dysfunction measures were associated with 5- and 10-year mortality. Conclusions: Days alive and free of ventilation, vasopressors, and renal replacement therapy in septic shock in 28-day survivors was associated with 1-, 5-, and 10-year mortality. These associations are nullified in 1-year survivors in whom none of the acute organ support measures were associated with 5- and 10-year mortality. This suggests that therapies that decrease short-term organ dysfunction could also improve long-term outcomes of 28-day survivors of septic shock.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Infektionsmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Infectious Medicine hsv//eng
long-term survival
organ dysfunction
renal replacement therapy
septic shock
vasopressors
ventilation

Added entries (persons, corporate bodies, meetings, titles ...)

Lee, TerryUniversity of British Columbia (author)
Fisher, JaneLund University,Lunds universitet,Infektionsmedicin,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Translationell Sepsisforskning,Forskargrupper vid Lunds universitet,Infection Medicine (BMC),Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Translational Sepsis research,Lund University Research Groups(Swepub:lu)med-jfi (author)
Singer, JoelUniversity of British Columbia (author)
Boyd, JohnUniversity of British Columbia (author)
Walley, Keith R.University of British Columbia (author)
Russell, James A.University of British Columbia (author)
InfektionsmedicinSektion III (creator_code:org_t)

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In:Critical Care Medicine44:8, s. 728-7360090-3493

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