1. Long-Term Outcomes in Critically Ill Septic Patients Who Survived Cardiopulmonary Resuscitation*
- Author
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Yu Ning Shih, Chia Jen Shih, Shu-Chen Kuo, Hsi Ning Chu, Shuo Ming Ou, Szu Yuan Li, Yung Tai Chen, and Pei Wen Chao
- Subjects
Male ,medicine.medical_specialty ,Time Factors ,Databases, Factual ,Critical Illness ,medicine.medical_treatment ,Taiwan ,Comorbidity ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Sepsis ,03 medical and health sciences ,Sex Factors ,0302 clinical medicine ,Risk Factors ,Epidemiology ,Long term outcomes ,medicine ,Humans ,Hospital Mortality ,Cardiopulmonary resuscitation ,Intensive care medicine ,Survival rate ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Critically ill ,Age Factors ,030208 emergency & critical care medicine ,Middle Aged ,Prognosis ,medicine.disease ,Cardiopulmonary Resuscitation ,Heart Arrest ,Survival Rate ,Cohort ,Female ,Observational study ,business - Abstract
To evaluate the long-term survival rate of critically ill sepsis survivors following cardiopulmonary resuscitation on a national scale.Retrospective and observational cohort study.Data were extracted from Taiwan's National Health Insurance Research Database.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.None.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.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.
- Published
- 2016