Long-term mortality and major adverse cardiovascular events in sepsis survivors a nationwide population-based study

Shuo Ming Ou, Hsi Ning Chu, Pei Wen Chao, Yi Jung Lee, Shu-Chen Kuo, Tzeng Ji Chen, Ching Min Tseng, Chia Jen Shih, Yung Tai Chen

Research output: Contribution to journalArticlepeer-review

148 Citations (Scopus)


Rationale: Patients with sepsis who survive to hospital discharge may present with ongoing high morbidity and mortality. However, little is known about the risk of long-term, all-cause mortality and cardiovascular outcomes after sepsis. Objectives: Our study aimed to investigate the long-term clinical outcomes in sepsis survivors. Methods: In this nationwide population-based study, data from patients with sepsis were retrieved from Taiwan's National Health Insurance Research Database between 2000 and 2002. Each sepsis survivor was 1:1 propensity-matched to control subjects from two different control populations: subjects who were in the general population and subjects who were hospitalized for a nonsepsis diagnosis. The primary outcomes were all-cause mortality, major adverse cardiovascular events, myocardial infarction, heart failure, stroke, and sudden cardiac death or ventricular arrhythmia. Measurements and Main Results: Compared with matched population control subjects, sepsis survivors had higher risks of all-cause mortality (hazard ratio [HR], 2.18; 95% confidence interval [CI], 2.14-2.22), major adverse cardiovascular events (HR, 1.37; 95% CI, 1.34-1.41), ischemic stroke (HR, 1.27; 95% CI, 1.23-1.32), hemorrhagic stroke (HR, 1.36; 95% CI, 1.26-1.46), myocardial infarction (HR, 1.22; 95% CI, 1.14-1.30), heart failure (HR, 1.48; 95% CI, 1.43-1.53), and sudden cardiac death or ventricular arrhythmia (HR, 1.65; 95% CI, 1.57-1.74). Similar results, although slightly attenuated risks, were found when comparisons were made with hospitalized control subjects without sepsis. Conclusions: These data indicate that sepsis survivors had substantially increased risks of subsequent all-cause mortality and major adverse cardiovascular events at 1 year after discharge, which persisted for up to 5 years after discharge.

Original languageEnglish
Pages (from-to)209-217
Number of pages9
JournalAmerican Journal of Respiratory and Critical Care Medicine
Issue number2
Publication statusPublished - Jul 15 2016


  • Epidemiology
  • Heart failure
  • Major adverse cardiovascular events
  • Mortality
  • Sepsis

ASJC Scopus subject areas

  • General Medicine
  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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