1. Long-Term Outcomes in Critically Ill Septic Patients Who Survived Cardiopulmonary Resuscitation.
- Author
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Pei-Wen Chao, Hsi Chu, Yung-Tai Chen, Yu-Ning Shih, Shu-Chen Kuo, Szu-Yuan Li, Shuo-Ming Ou, Chia-Jen Shih, Chao, Pei-Wen, Chu, Hsi, Chen, Yung-Tai, Shih, Yu-Ning, Kuo, Shu-Chen, Li, Szu-Yuan, Ou, Shuo-Ming, and Shih, Chia-Jen
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CRITICALLY ill patient care , *SEPSIS , *CARDIOPULMONARY resuscitation , *COHORT analysis , *MORTALITY , *PATIENTS , *THERAPEUTICS , *AGE distribution , *CARDIAC arrest , *CATASTROPHIC illness , *DATABASES , *PROGNOSIS , *SEX distribution , *SURVIVAL , *TIME , *COMORBIDITY , *RETROSPECTIVE studies , *HOSPITAL mortality , *DISEASE complications - Abstract
Objective: To evaluate the long-term survival rate of critically ill sepsis survivors following cardiopulmonary resuscitation on a national scale.Design: Retrospective and observational cohort study.Setting: Data were extracted from Taiwan's National Health Insurance Research Database.Patients: A total of 272,897 ICU patients with sepsis were identified during 2000-2010. Patients who survived to hospital discharge were enrolled. Post-discharge survival outcomes of ICU sepsis survivors who received cardiopulmonary resuscitation were compared with those of patients who did not experience cardiopulmonary arrest using propensity score matching with a 1:1 ratio.Intervention: None.Measurements and Main Results: Only 7% (n = 3,207) of sepsis patients who received cardiopulmonary resuscitation survived to discharge. The overall 1-, 2-, and 5-year postdischarge survival rates following cardiopulmonary resuscitation were 28%, 23%, and 14%, respectively. Compared with sepsis survivors without cardiopulmonary arrest, sepsis survivors who received cardiopulmonary resuscitation had a greater risk of all-cause mortality after discharge (hazard ratio, 1.38; 95% CI, 1.34-1.46). This difference in mortality risk diminished after 2 years (hazard ratio, 1.11; 95% CI, 0.96-1.28). Multivariable analysis showed that independent risk factors for long-term mortality following cardiopulmonary resuscitation were male sex, older age, receipt of care in a nonmedical center, higher Charlson Comorbidity Index score, chronic kidney disease, cancer, respiratory infection, vasoactive agent use, and receipt of renal replacement therapy during ICU stay.Conclusion: The long-term outcome was worse in ICU survivors of sepsis who received in-hospital cardiopulmonary resuscitation than in those who did not, but this increased risk of mortality diminished at 2 years after discharge. [ABSTRACT FROM AUTHOR]- Published
- 2016
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