Danish researchers have found that half of patients with sepsis die within two years of emergency admission and identified key risk factors such as age, previous sepsis hospitalization and chronic disease. The study, presented at the European Congress of Emergency Medicine, highlights the need for targeted care and further research to improve sepsis treatments.

Danish researchers found that half of patients with sepsis admitted to emergency departments died within two years.

Dr. Finn E. Nielsen, a senior scientist at the Department of Clinical Epidemiology at Aarhus University Hospital in Denmark, said today (Tuesday, October 15) at the European Congress of Emergency Medicine that he and his colleagues conducted long-term follow-up on 714 adult patients with sepsis admitted to the emergency department and studied death cases. Their findings revealed several risk factors associated with sepsis-related death.

"We found, not surprisingly, that certain factors increase the risk of death after sepsis, including older age. In addition, conditions such as dementia, heart disease, cancer, and hospitalization for sepsis within 6 months before admission also increased the risk of death during a median follow-up of two years."

In a 2020 report, the World Health Organization (WHO) highlighted limitations and gaps in knowledge about sepsis outcomes, with existing studies varying in design, data sources, and definitions of sepsis, all of which lead to considerable variation in estimates of sepsis incidence and deaths. WHO calls for prospective studies to investigate the long-term outcomes of patients with sepsis.

Dr. Nelson, a specialist in emergency medicine, cardiology and internal medicine, founded the Sepsis Research Group in the emergency department in 2017. The current study examined outcomes for patients admitted to hospital with sepsis between October 2017 and the end of March 2018.

"Our study relies on a sepsis database that provides valuable information based on prospectively collected patient data. Unlike often used routine registry data, this approach minimizes error and allows for a more accurate and detailed understanding of the impact of sepsis."

A total of 2110 patients with suspected infection were included in this study, 714 of whom suffered from sepsis. The researchers obtained death data from the Danish Registration System, which provides up-to-date information on all Danish citizens. They found that after a median of two years, 361 (50.6%) patients with sepsis died from any cause, including sepsis. For every additional year of age, the risk of death increases by 4%.

In addition, a history of cancer more than doubled the risk of death (121%), ischemic heart disease (a disease in which the arteries supplying blood to the heart become narrowed or blocked by fatty deposits) increased the risk of death by 39%, dementia increased the risk of death by 90%, and being hospitalized with sepsis in the past six months increased the risk of death by 48%.

"Our study identified several risk factors that health care providers should prioritize for information, care, and follow-up. We believe this knowledge will be useful to both clinicians and researchers in the acute medicine field," said Dr. Nielsen. "It is critical to recognize that sepsis is a serious disease with a high mortality rate."

Since this study was conducted at a single center, further investigation in larger prospective studies is needed.

"In this study, we sought to fill some gaps in our understanding of the epidemiology of sepsis. Unlike many other studies, our investigation was based on prospective electronic health records. Similar but larger studies of sepsis-related outcomes are needed to be repeated in different sectors, regions and countries to fully understand the epidemiology of sepsis, including the long-term prognostic aspects of physical, mental and cognitive impairment, and the potential impact of these factors on the risk of death."

Dr. Nelson and his colleagues tried to develop a model that could predict long-term mortality risk, but found that its predictive power was not good enough.

"Although we identified several risk factors that clearly increase the risk of death and should be the focus of clinicians and researchers during the discharge planning process and in future prediction studies, we were unable to construct an overall model suitable for predicting mortality in clinical practice," he said. "Prospective studies of the impact of other factors not examined in our study, including the various complications that may arise after hospitalization and after discharge, are warranted."

Dr. Nielsen added: "We will present supplementary data at the meeting. Adding organ failure scores to more complex models improves the ability to predict long-term mortality risk after hospitalization. This has potential applications in clinical practice and future research."

Dr. Barbra Backus chairs the EUSEM Abstract Selection Committee. She is an emergency physician in Rotterdam, the Netherlands, and was not involved in the study. She said: "Sepsis is a serious and potentially fatal disease. The incidence of sepsis is rising in some countries, but to date, reliable information on the long-term outcomes of patients with sepsis is limited. This study shows certain risk factors that should alert clinicians to the increased risk of death in patients with sepsis so that they can be monitored and followed more closely. More research is needed to help us better understand the risk factors for increased risk of death from sepsis, which can help improve treatment."

Compiled from/SciTechDaily