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Long-Term Outcomes in Critically Ill Septic Patients Who Survived Cardiopulmonary Resuscitation*
- Source :
- Critical Care Medicine. 44:1067-1074
- Publication Year :
- 2016
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2016.
-
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.
- 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
Subjects
Details
- ISSN :
- 00903493
- Volume :
- 44
- Database :
- OpenAIRE
- Journal :
- Critical Care Medicine
- Accession number :
- edsair.doi.dedup.....70c02d49f9e1059e6789155e58a0b4e9