Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/105181
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dc.contributor.authorOu, L.en
dc.contributor.authorChen, J.en
dc.contributor.authorHillman, K.en
dc.contributor.authorFlabouris, A.en
dc.contributor.authorParr, M.en
dc.contributor.authorAssareh, H.en
dc.contributor.authorBellomo, R.en
dc.date.issued2017en
dc.identifier.citationCritical Care, 2017; 21(1):34-1-34-13en
dc.identifier.issn1364-8535en
dc.identifier.issn1466-609Xen
dc.identifier.urihttp://hdl.handle.net/2440/105181-
dc.description.abstractOur aim in the present study was to assess the mortality impact of hospital-acquired post-operative sepsis up to 1 year after hospital discharge among adult non-short-stay elective surgical patients.We conducted a population-based, retrospective cohort study of all elective surgical patients admitted to 82 public acute hospitals between 1 January 2007 and 31 December 2012 in New South Wales, Australia. All adult elective surgical admission patients who stayed in hospital for ≥4 days and survived to discharge after post-operative sepsis were identified using the Admitted Patient Data Collection records linked with the Registry of Births, Deaths, and Marriages. We assessed post-discharge mortality rates at 30 days, 60 days, 90 days and 1 year and compared them with those of patients without post-operative sepsis.We studied 144,503 survivors to discharge. Of these, 1857 (1.3%) had experienced post-operative sepsis. Their post-discharge mortality rates at 30 days, 60 days, 90 days and 1 year were 4.6%, 6.7%, 8.1% and 13.5% (vs 0.7%, 1.2%, 1.5% and 3.8% in the non-sepsis cohort), respectively (P < 0.0001 for all). After adjustment for patient and hospital characteristics, post-operative sepsis remained independently associated with a higher mortality risk (30-day mortality HR 2.75, 95% CI 2.14-3.53; 60-day mortality HR 2.45, 95% CI 1.94-3.10; 90-day mortality HR 2.31, 95% CI 1.85-2.87; 1-year mortality HR 1.71, 95% CI 1.46-2.00). Being older than 75 years of age (HR 3.50, 95% CI 1.56-7.87) and presence of severe/very severe co-morbidities as defined by Charlson co-morbidity index (severe vs normal HR 2.05, 95% CI 1.45-2.89; very severe vs normal HR 2.17, 95% CI 1.49-3.17) were the only other significant independent predictors of increased 1-year mortality.Among elective surgical patients, post-operative sepsis is independently associated with increased post-discharge mortality up to 1 year after hospital discharge. This risk is particularly high in the first month, in older age patients and in the presence of severe/very severe co-morbidities. This high-risk population can be targeted for interventions.en
dc.description.statementofresponsibilityLixin Ou, Jack Chen, Ken Hillman, Arthas Flabouris, Michael Parr, Hassan Assareh and Rinaldo Bellomoen
dc.language.isoenen
dc.publisherBioMed Centralen
dc.rights© The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.subjectHumans; Cross Infection; Sepsis; Postoperative Complications; Patient Discharge; Registries; Hospital Mortality; Multivariate Analysis; Proportional Hazards Models; Risk Factors; Chi-Square Distribution; Poisson Distribution; Retrospective Studies; Cohort Studies; Adult; Aged; Aged, 80 and over; Middle Aged; New South Wales; Female; Male; Elective Surgical Proceduresen
dc.titleThe impact of post-operative sepsis on mortality after hospital discharge among elective surgical patients: a population-based cohort studyen
dc.typeJournal articleen
dc.identifier.rmid0030065039en
dc.identifier.doi10.1186/s13054-016-1596-7en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1020660en
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1009916en
dc.identifier.pubid289982-
pubs.library.collectionMedicine publicationsen
pubs.library.teamDS10en
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
dc.identifier.orcidFlabouris, A. [0000-0002-1535-9441]en
Appears in Collections:Medicine publications

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