Finn Erland Nielsen, Lana Chafranska, Rune H Sørensen, Thomas Andersen Schmidt, Osama Bin Abdullah
{"title":"败血症的两年死亡率和预后因素：一项对714名丹麦急诊科患者的前瞻性队列研究","authors":"Finn Erland Nielsen, Lana Chafranska, Rune H Sørensen, Thomas Andersen Schmidt, Osama Bin Abdullah","doi":"10.2147/CLEP.S524819","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":10362,"journal":{"name":"Clinical Epidemiology","volume":"17 ","pages":"581-592"},"PeriodicalIF":3.4000,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222623/pdf/","citationCount":"0","resultStr":"{\"title\":\"Two-Year Mortality and Prognostic Factors in Sepsis: A Prospective Cohort Study of 714 Danish Emergency Department Patients.\",\"authors\":\"Finn Erland Nielsen, Lana Chafranska, Rune H Sørensen, Thomas Andersen Schmidt, Osama Bin Abdullah\",\"doi\":\"10.2147/CLEP.S524819\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>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.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":10362,\"journal\":{\"name\":\"Clinical Epidemiology\",\"volume\":\"17 \",\"pages\":\"581-592\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-06-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222623/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/CLEP.S524819\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/CLEP.S524819","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Two-Year Mortality and Prognostic Factors in Sepsis: A Prospective Cohort Study of 714 Danish Emergency Department Patients.
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.
期刊介绍：
Clinical Epidemiology is an international, peer reviewed, open access journal. Clinical Epidemiology focuses on the application of epidemiological principles and questions relating to patients and clinical care in terms of prevention, diagnosis, prognosis, and treatment.
Clinical Epidemiology welcomes papers covering these topics in form of original research and systematic reviews.
Clinical Epidemiology has a special interest in international electronic medical patient records and other routine health care data, especially as applied to safety of medical interventions, clinical utility of diagnostic procedures, understanding short- and long-term clinical course of diseases, clinical epidemiological and biostatistical methods, and systematic reviews.
When considering submission of a paper utilizing publicly-available data, authors should ensure that such studies add significantly to the body of knowledge and that they use appropriate validated methods for identifying health outcomes.
The journal has launched special series describing existing data sources for clinical epidemiology, international health care systems and validation studies of algorithms based on databases and registries.
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