Two-Year Mortality and Prognostic Factors in Sepsis: A Prospective Cohort Study of 714 Danish Emergency Department Patients

Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis. Prospective cohort study. This study included all emergency department pati...

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Published inClinical epidemiology Vol. 17; no. Issue 1; pp. 581 - 592
Main Authors Nielsen, Finn, Chafranska, Lana, Sørensen, Rune, Schmidt, Thomas, Abdullah, Osama
Format Journal Article
LanguageEnglish
Published New Zealand Dove Medical Press Limited 01.01.2025
Taylor & Francis Ltd
Dove
Dove Medical Press
Subjects
24-month mortality
Analysis
Antibiotics
Blood
Cardiac arrhythmia
Chronic illnesses
Cohort analysis
Communicable diseases
Comorbidity
Creatinine
Data collection
Dementia
Diabetes
Electrocardiography
Electronic health records
Emergency medical care
Emergency service
Emigration
Epidemiology
Heart
Heart diseases
Hemoglobin
Hospitals
Infection
Infections
Leukocytes
Medical prognosis
Medical records
Medical research
Medicine, Experimental
Mortality
Original Research
Patient outcomes
Patients
Prognosis
prognostic factors
prospective cohort study
Registration
Sensitivity analysis
Sepsis
Survival analysis
Variables
Denmark
prognostic factors
prospective cohort study
2-year mortality
sepsis
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Abstract Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis. Prospective cohort study. This study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score ≥ 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality. A total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9-53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65-85 years (aHR 1.89; 1.35-2.64) or age > 85 years (aHR 2.99; 2.07-4.31); SOFA score > 4 (aHR 2.45; 1.82-3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44-2.53), ischemic heart disease (aHR 1.38; 1.03-1.84), dementia (aHR 1.84; 1.34-2.53), previous sepsis admission (aHR 1.45; 1.15-1.82), new-onset atrial fibrillation (aHR 1.56; 1.05-2.34), and mildly decreased (6.9-7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29-2.19) and significantly decreased (<6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74-3.02) with normal range (≥ 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29-0.85) compared to patients with other sources of infection. Sepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis.
AbstractList Objective: Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis. Study Design: Prospective cohort study. Methods: This study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score [greater than or equal to] 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality. Results: A total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9-53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65-85 years (aHR 1.89; 1.35-2.64) or age > 85 years (aHR 2.99; 2.07-4.31); SOFA score > 4 (aHR 2.45; 1.82-3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44-2.53), ischemic heart disease (aHR 1.38; 1.03-1.84), dementia (aHR 1.84; 1.34-2.53), previous sepsis admission (aHR 1.45; 1.15-1.82), new-onset atrial fibrillation (aHR 1.56; 1.05-2.34), and mildly decreased (6.9-7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29-2.19) and significantly decreased (<6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74-3.02) with normal range ([greater than or equal to] 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29-0.85) compared to patients with other sources of infection. Conclusion: Sepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis. Keywords: sepsis, prospective cohort study, 2-year mortality, prognostic factors
Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis. Prospective cohort study. This study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score ≥ 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality. A total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9-53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65-85 years (aHR 1.89; 1.35-2.64) or age > 85 years (aHR 2.99; 2.07-4.31); SOFA score > 4 (aHR 2.45; 1.82-3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44-2.53), ischemic heart disease (aHR 1.38; 1.03-1.84), dementia (aHR 1.84; 1.34-2.53), previous sepsis admission (aHR 1.45; 1.15-1.82), new-onset atrial fibrillation (aHR 1.56; 1.05-2.34), and mildly decreased (6.9-7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29-2.19) and significantly decreased (<6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74-3.02) with normal range (≥ 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29-0.85) compared to patients with other sources of infection. Sepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis.
Finn Erland Nielsen,1,2 Lana Chafranska,3 Rune H Sørensen,1 Thomas Andersen Schmidt,4,5 Osama Bin Abdullah1 1Department of Emergency Medicine, Slagelse Hospital, Slagelse, Denmark; 2Department of Clinical Medicine, Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Department of Anaesthesiology, Copenhagen University Hospital – North Zealand, Hilleroed, Denmark; 4Department of Emergency Medicine, Copenhagen University Hospital – North Zealand, Hilleroed, Denmark; 5Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, DenmarkCorrespondence: Finn Erland Nielsen, Email fenielsen@dadlnet.dkObjective: Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis.Study Design: Prospective cohort study.Methods: This study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score ≥ 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality.Results: A total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9– 53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65– 85 years (aHR 1.89; 1.35– 2.64) or age > 85 years (aHR 2.99; 2.07– 4.31); SOFA score > 4 (aHR 2.45; 1.82– 3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44– 2.53), ischemic heart disease (aHR 1.38; 1.03– 1.84), dementia (aHR 1.84; 1.34– 2.53), previous sepsis admission (aHR 1.45; 1.15– 1.82), new-onset atrial fibrillation (aHR 1.56; 1.05– 2.34), and mildly decreased (6.9– 7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29– 2.19) and significantly decreased (< 6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74– 3.02) with normal range (≥ 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29– 0.85) compared to patients with other sources of infection.Conclusion: Sepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis.Keywords: sepsis, prospective cohort study, 2-year mortality, prognostic factors
Objective: Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis.Study Design: Prospective cohort study.Methods: This study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score ≥ 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality.Results: A total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9– 53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65– 85 years (aHR 1.89; 1.35– 2.64) or age > 85 years (aHR 2.99; 2.07– 4.31); SOFA score > 4 (aHR 2.45; 1.82– 3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44– 2.53), ischemic heart disease (aHR 1.38; 1.03– 1.84), dementia (aHR 1.84; 1.34– 2.53), previous sepsis admission (aHR 1.45; 1.15– 1.82), new-onset atrial fibrillation (aHR 1.56; 1.05– 2.34), and mildly decreased (6.9– 7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29– 2.19) and significantly decreased (< 6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74– 3.02) with normal range (≥ 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29– 0.85) compared to patients with other sources of infection.Conclusion: Sepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis.
Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis.ObjectiveGiven the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with mortality in adults admitted to an emergency department with sepsis.Prospective cohort study.Study DesignProspective cohort study.This study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score ≥ 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality.MethodsThis study included all emergency department patients admitted with sepsis to Slagelse Hospital, Denmark, between October 1, 2017, and March 31, 2018. Data on patients with infectious diseases was prospectively extracted from electronic health records during the study period. Sepsis was defined as a Sequential Organ Failure Assessment (SOFA) score ≥ 2 from baseline. The outcome was 2-year all-cause mortality. The Kaplan-Meier method was used to estimate the mortality. Cox regression analyses were used to compute adjusted hazard ratios (aHR) with 95% confidence intervals for prognostic factors associated with mortality.A total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9-53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65-85 years (aHR 1.89; 1.35-2.64) or age > 85 years (aHR 2.99; 2.07-4.31); SOFA score > 4 (aHR 2.45; 1.82-3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44-2.53), ischemic heart disease (aHR 1.38; 1.03-1.84), dementia (aHR 1.84; 1.34-2.53), previous sepsis admission (aHR 1.45; 1.15-1.82), new-onset atrial fibrillation (aHR 1.56; 1.05-2.34), and mildly decreased (6.9-7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29-2.19) and significantly decreased (<6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74-3.02) with normal range (≥ 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29-0.85) compared to patients with other sources of infection.ResultsA total of 714 patients (58.4% men) with a median age of 75 years were diagnosed with sepsis. After two years, 354 (49.6%; 45.9-53.3) patients had died. Factors associated with elevated mortality risk included age (< 65 years as reference) 65-85 years (aHR 1.89; 1.35-2.64) or age > 85 years (aHR 2.99; 2.07-4.31); SOFA score > 4 (aHR 2.45; 1.82-3.30) (score of 2 as reference); and history of malignancy (aHR 1.91; 1.44-2.53), ischemic heart disease (aHR 1.38; 1.03-1.84), dementia (aHR 1.84; 1.34-2.53), previous sepsis admission (aHR 1.45; 1.15-1.82), new-onset atrial fibrillation (aHR 1.56; 1.05-2.34), and mildly decreased (6.9-7.9 mmmol/L) hemoglobin values (aHR 1.68; 1.29-2.19) and significantly decreased (<6.9 mmol/L) hemoglobin values (aHR 2.30; 1.74-3.02) with normal range (≥ 8mmol/L) as reference. Skin infection was associated with diminished mortality risk (aHR 0.50; 0.29-0.85) compared to patients with other sources of infection.Sepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis.ConclusionSepsis is associated with a poor prognosis. Our findings underscore the prognostic effects of age, SOFA score, and specific comorbidities on 2-year mortality among patients with sepsis.
Audience Academic
Author Sørensen, Rune
Schmidt, Thomas
Abdullah, Osama
Nielsen, Finn
Chafranska, Lana
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PublicationCentury 2000
PublicationDate 2025-01-01
PublicationDateYYYYMMDD 2025-01-01
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PublicationDecade 2020
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Taylor & Francis Ltd
Dove
Dove Medical Press
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Snippet Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors associated with...
Objective: Given the lack of data on long-term outcomes among patients with sepsis, this study aimed to examine all-cause 2-year mortality and factors...
Finn Erland Nielsen,1,2 Lana Chafranska,3 Rune H Sørensen,1 Thomas Andersen Schmidt,4,5 Osama Bin Abdullah1 1Department of Emergency Medicine, Slagelse...
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StartPage 581
SubjectTerms 24-month mortality
Analysis
Antibiotics
Blood
Cardiac arrhythmia
Chronic illnesses
Cohort analysis
Communicable diseases
Comorbidity
Creatinine
Data collection
Dementia
Diabetes
Electrocardiography
Electronic health records
Emergency medical care
Emergency service
Emigration
Epidemiology
Heart
Heart diseases
Hemoglobin
Hospitals
Infection
Infections
Leukocytes
Medical prognosis
Medical records
Medical research
Medicine, Experimental
Mortality
Original Research
Patient outcomes
Patients
Prognosis
prognostic factors
prospective cohort study
Registration
Sensitivity analysis
Sepsis
Survival analysis
Variables
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Title Two-Year Mortality and Prognostic Factors in Sepsis: A Prospective Cohort Study of 714 Danish Emergency Department Patients
URI https://www.ncbi.nlm.nih.gov/pubmed/40611915
https://www.proquest.com/docview/3230209987
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https://pubmed.ncbi.nlm.nih.gov/PMC12222623
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Volume 17
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