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Health-related outcomes of critically ill patients with and without sepsis

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Abstract

Purpose

To determine differences in health-related quality of life (HRQoL), survival and healthcare resource use of critically ill adults with and without sepsis.

Methods

We conducted a primary propensity score matched analysis of patients with and without sepsis enrolled in a large multicentre clinical trial. Outcomes included HRQoL at 6 months, survival to 2 years, length of ICU and hospital admission and cost of ICU and hospital treatment to 2 years.

Results

We obtained linked data for 3442 (97.3%) of 3537 eligible patients and matched 806/905 (89.0%) patients with sepsis with 806/2537 (31.7%) without. After matching, there were no significant differences in the proportion of survivors with and without sepsis reporting problems with mobility (37.8% vs. 38.7%, p = 0.86), self-care (24.7% vs. 26.0%, p = 0.44), usual activities (44.5% vs. 46.8%, p = 0.28), pain/discomfort (42.4% vs. 41.6%, p = 0.54) and anxiety/depression (36.9% vs. 37.7%, p = 0.68). There was no significant difference in survival at 2 years: 482/792 (60.9%) vs. 485/799 (60.7%) (HR 1.01, 95% CI 0.86–1.18, p = 0.94). The initial ICU and hospital admission were longer for patients with sepsis: 10.1 ± 11.9 vs. 8.0 ± 9.8 days (p < 0.0001) and 22.8 ± 21.2 vs. 19.1 ± 19.0 days, (p = 0.0003) respectively. The cost of ICU admissions was higher for patients with sepsis: A$43,345 ± 46,263 (€35,109 ± 35,043) versus 34,844 ± 38,281 (€28,223 ± 31,007), mean difference $8501 (€6885), 95% CI $4342–12,660 (€3517 ± 10,254), p < 0.001 as was the total cost of hospital treatment to 2 years: A$74,120 ± 60,750 (€60,037 ± 49,207) versus A$65,806 ± 59,856 (€53,302 ± 48,483), p = 0.005.

Conclusions

Critically ill patients with sepsis have higher healthcare resource use and costs but similar survival and HRQoL compared to matched patients without sepsis.

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Authors and Affiliations

  1. The George Institute for Global Health, Sydney, Australia

    Kelly Thompson, Colman Taylor, Stephen Jan, Qiang Li, Naomi Hammond, John Myburgh, Manoj Saxena, Balasubramanian Venkatesh & Simon Finfer

  2. University of New South Wales, Sydney, Australia

    Kelly Thompson, Colman Taylor, Stephen Jan, Naomi Hammond, John Myburgh, Manoj Saxena, Balasubramanian Venkatesh & Simon Finfer

  3. Sydney Medical School, University of Sydney, Sydney, Australia

    Naomi Hammond & Simon Finfer

  4. Malcolm Fisher Department of Intensive Care Medicine, Royal North Shore Hospital, Sydney, Australia

    Naomi Hammond & Simon Finfer

  5. St George Clinical School, University of New South Wales, Sydney, Australia

    John Myburgh & Manoj Saxena

  6. The Princess Alexandra Hospital, University of Queensland, Brisbane, Australia

    Balasubramanian Venkatesh

  7. The Wesley Hospital, Brisbane, Australia

    Balasubramanian Venkatesh

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  1. Kelly Thompson
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  2. Colman Taylor
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Correspondence to Kelly Thompson.

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Thompson, K., Taylor, C., Jan, S. et al. Health-related outcomes of critically ill patients with and without sepsis. Intensive Care Med 44, 1249–1257 (2018). https://doi.org/10.1007/s00134-018-5274-x

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