Wilhelms Susanne B, Walther Sten M, Sjöberg Folke, De Geer Lina
Department of Anaesthesia and Intensive Care and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
Department of Cardiothoracic Anaesthesia and Intensive Care and Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Acta Anaesthesiol Scand. 2020 Aug;64(7):961-966. doi: 10.1111/aas.13592. Epub 2020 Apr 22.
Patients with sepsis may have an increased risk of late mortality, but the causes of late death are unclear. This retrospective matched cohort study aimed to determine the causes of late death (≥1 year) among patients with sepsis compared to patients without sepsis.
8760 patients with severe sepsis or septic shock (2001 consensus criteria) registered in the Swedish Intensive Care Registry (2008-2013) were compared with a 1:1 matched (gender, age, SAPS3 probability for death, ICU length of stay) control group consisting of non-septic ICU patients. Causes of death (International Classification of Diseases codes) were obtained from the Swedish Cause of Death Register (2008-2014).
During 2008-2014, 903 patients with sepsis died at ≥365 days after their initial septic event, compared to 884 patients in the control group. Median time of follow-up was 313 days (sepsis group, interquartile range 11-838 days) vs 288 days (control group, 9-836 days). The most common causes of death were heart diseases (sepsis: 50.2%, non-septic: 48.6%) and cancer (sepsis: 33.7%, non-septic: 31.7%). Infectious diseases were significantly more common cause of death in the sepsis group (24.3% vs 19.6%, respectively; P < .05). Pneumonia was a common infectious cause of death in both groups, whereas sepsis was more common in the sepsis group.
The most common causes of late death after ICU admission among patients with and without sepsis were heart diseases and cancer. However, patients with sepsis more frequently had infectious diseases as a cause of late death, compared to non-septic patients.
脓毒症患者后期死亡风险可能增加，但后期死亡原因尚不清楚。这项回顾性匹配队列研究旨在确定脓毒症患者与非脓毒症患者相比后期死亡（≥1年）的原因。
将瑞典重症监护登记处（2008 - 2013年）登记的8760例严重脓毒症或脓毒性休克患者（2001年共识标准）与由非脓毒症重症监护患者组成的1:1匹配（性别、年龄、SAPS3死亡概率、重症监护病房住院时间）对照组进行比较。死亡原因（国际疾病分类编码）来自瑞典死亡原因登记处（2008 - 2014年）。
在2008 - 2014年期间，903例脓毒症患者在≥365天之后死亡，而对照组有884例患者死亡。脓毒症组的中位随访时间为313天（四分位间距11 - 838天），对照组为288天（9 - 836天）。最常见的死亡原因是心脏病（脓毒症组：50.2%，非脓毒症组：48.6%）和癌症（脓毒症组：33.7%，非脓毒症组：31.7%）。脓毒症组中，传染病作为死亡原因更为常见（分别为24.3%和19.6%；P < 0.05）。肺炎是两组常见的感染性死亡原因，而脓毒症在脓毒症组中更为常见。
入住重症监护病房后，脓毒症患者和非脓毒症患者后期死亡的最常见原因是心脏病和癌症。然而，与非脓毒症患者相比，脓毒症患者因传染病导致后期死亡的情况更为频繁。
