(1416) Long-Term Mortality From Sepsis in Catalonia According to Demographic Variables and Comorbidity

Introduction: In recent years, a marked reduction in in-hospital mortality associated with sepsis has been observed, probably related to advances in early detection and improved therapeutic management. However, very few studies have evaluated the long-term mortality of those patients who have survived a hospital admission for sepsis. The objective of this study is to determine the mortality 2 years after hospital discharge of those patients who suffered sepsis in Catalonia.

Methods: This is a retrospective analysis based on the records of hospital discharges from the Minimum Basic Data Set of Acute Hospitals (CMBD-HA, in spanish) of the Catalan Health System from January 1, 2005 to December 31, 2019. The CMBD-HA is a mandatory population registry of admissions in all acute care hospitals in Catalonia. Sepsis was defined by the presence of infection and at least one organ dysfunction. The ICD-9 and ICD-10 coding systems were used to identify cases (infectious process coding + organic dysfunction). Follow-up was performed on all detected cases that survived the episode for survival analysis 2 years after hospital discharge.

Results: A total of 237,075 patients who survived a hospital admission for sepsis during the study period were detected. 55.9% were men, with a mean age of 72.3(+/-18.7) years and a mean hospital stay of 15.5(+/-24.8) days. Overall mortality two years after hospital discharge was 41.7%, higher in men (43.7% vs 40.4%, p< 0.0001), increased proportionally with age ( < 15 years=5.5%, 15-45=10.4%, 45-64=13.9%, 65-74=22.2%, 75 -84=45.1%, >84=62.8%, p< 0.0001) and with comorbidity (Charlson Index (CI) of 0=20.6%, CI 1-2=38.1%, CI 3-4=51.2% , CI≥5=66.9%, p< 0.0001). Mortality at 2 years was different depending on the septic focus that led to admission (respiratory=45.6%, genitourinary=45%, unknown focus=42.5%, skin & soft tissue=41.3%, sepsis related to intravascular devices=34.4%, abdominal = 31.9%, neurological=17.5%, p< 0.0001).

Conclusions: Despite the fact that in-hospital mortality from sepsis has decreased significantly in recent years, mortality 2 years after hospital discharge is very high. Various risk factors have been identified that increase this mortality in the long term, such as gender, age, previous comorbidity or the focus of sepsis, among others.