Photo Credit: YakobchukOlena

The following is a summary of “Three-year mortality of ICU survivors with sepsis, an infection or an inflammatory illness: an individually matched cohort study of ICU patients in the Netherlands from 2007 to 2019,” published in the November 2024 issue of Critical Care by Arbous et al. 

Sepsis, a leading cause of ICU admissions and death, has seen a rising incidence, with long-term sequelae contributing to significant mortality even years after post-hospitalization.  

Researchers conducted a retrospective study to evaluate the 3-year mortality of patients admitted admitted to ICU with sepsis, infection without sepsis, and inflammatory illness without infection to disentangle the relative contribution of the factors to long-term survival.  

They assessed adult ICU survivors admitted between January 1, 2007, and January 1, 2019, with sepsis, infection, or inflammatory illness. Patients were classified within 24 hours of ICU admission based on APACHE IV admission diagnoses. Data from 78 Dutch ICUs were prospectively recorded in the NICE (National Intensive Care Evaluation) registry, which included demographic and clinical information for all ICU admissions. These data were linked to a health care insurance claims database to obtain 3-year mortality data. Sensitivity analyses with varying definitions of infection and inflammatory illness cohorts were performed to better distinguish the sepsis group from the non-sepsis infection and inflammatory condition.  

The results showed that the 3-year mortality after discharge was 32.7% for patients with sepsis (N=10,000), 33.6% with infection (N=10,000), and 23.8% with inflammatory illness (N=9997). Compared to sepsis, the adjusted hazard ratio (HR) for death within 3 years after hospital discharge was 1.00 (95% CI 0.95-1.05) for patients with infection and 0.88 (95% CI 0.83-0.94) for patients with inflammatory illness.  

Investigators concluded both the patients with sepsis and non-sepsis infection had a more elevated risk of long-term mortality compared to inflammatory illness. This suggests that ICU admission due to infection, regardless of sepsis, increases the risk of long-term mortality, highlighting the need for improved post-ICU care. 

Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-05165-x