Journal Club - Recent Additions

October - 2014


Showing Journal 1 of 12

Long-Term (10-Year) Mortality of Younger Previously Healthy Patients With Severe Sepsis/ Septic Shock Is Worse Than That of Patients With Nonseptic Critical Illness and of the General Population

Adam Linder, Daphne Guh, John H. Boyd, Keith R. Walley, Aslam H. Anis, James A. Russell Crit Care Med, 2014, 42(10);2211-2218


Long-term mortality rates after sepsis are reported as 11-42% at 1-year, and 21-54% at 3-5 years. The authors tell us that…"it is not known whether long-term mortality rates of previously healthy persons who develop severe sepsis and septic shock differ from patients with...


Previous Comments

I struggle a bit with the age conclusions. The subgroups are a bit weird (<60, 60-70, >70) and may reflect poor numbers in the 'young people' group. It's not surprising to me that any of these groups have higher mortality than the general population and I'm not sure the reason for the comparison. There are a lot of confounders and I'm not sure there are enough previously healthy CVS or general ICU patients in the younger age group to provide a solid denominator? Notably, in the kaplan-mier curves most of the mortality difference was established in the first year. Interestingly, there primary hypothesis was to compare mortality rates septic patients with comorbidities and those that were previously healthy. This was significant - also not surprising? But not in the title of a paper? Instead the title emphasizes the age analysis which to me isn't well premeditated and likely reflects post-hoc analysis. I think leaping to conclusions that sepsis somatic injury that results in worse longterm outcomes than other critical illness is an interesting hypothesis but perhaps weakly supported by this paper?
Cynthia-03 Nov, 2014 09:14:45 AM