Long-Term Mortality in Sepsis Survivors: A Population-Based Study During 15 Years
In brief
Two in five sepsis survivors died within two years of discharge
In this population-based study in Catalonia, 42% of 237,075 adults and children who survived sepsis hospitalization died within two years of discharge. Mortality rose sharply with age and comorbidity burden, while rates declined in 2017 to 2019; the retrospective study cannot explain that decline, underscoring the need to identify high-risk survivors for follow-up.
- Journal
- Critical care medicine (Q1)
- Published
- 5 November 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Carolina Lorencio-Cárdenas, Emili Vela, Elisabeth Esteban-Torné, Clara Reina, Anna Maria Horta-Puig, Roger Ferret-Sánchez, et al.
- PMID
- 42987192
- DOI
- 10.1097/CCM.0000000000007415
Why clinicians should know about it
- Picked for Epidemiology (paper of the day, 8 November 2026): Large population-based cohort quantifies sepsis survivorship and mortality determinants
- Picked for Internal Medicine (paper of the day, 8 November 2026): Sepsis survivorship, long-term mortality, and multimorbidity
Abstract
OBJECTIVES: To evaluate long-term mortality among sepsis survivors in Catalonia over a 15-year period and to identify factors associated with increased mortality within 2 years after hospital discharge. DESIGN: Retrospective population-based cohort study. SETTING: Acute-care hospitals in Catalonia, Spain. PATIENTS: Adult and pediatric patients hospitalized with sepsis between 2005 and 2019 identified using the International Classification of Diseases, 9th Revision, Clinical Modification and International Classification of Diseases, 10th Revision, Clinical Modification codes for infection and acute organ dysfunction. Patients who died during hospitalization, were transferred to another facility, or represented readmission episodes were excluded. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data were obtained from the Catalan Minimum Basic Dataset of Acute-Care Hospitals, with longitudinal follow-up through the Central Registry of Insured Persons. Comorbidities were assessed using the Charlson comorbidity index. Logistic regression and Cox proportional hazards models were used to identify predictors of long-term mortality. Among 296,554 hospital admissions for sepsis, 237,075 patients (79.9%) survived to hospital discharge. Of these, 42% died (99,571) within 2 years. Long-term mortality increased significantly with age, ranging from 5.8% in patients younger than 15 years to 62% in those older than 84 years (p < 0.0001), and with comorbidity burden (21%, 38%, 51%, and 67% for Charlson index 0, 1-2, 3-4, and ≥ 5, respectively; p < 0.0001). Neoplasia (hazard ratio [HR], 2.011), liver cirrhosis (HR, 1.562), and dementia (HR, 1.304) were the comorbidities most strongly associated with mortality. Longer hospital stays were also associated with increased mortality. A progressive decline in long-term mortality was observed during 2017-2019. CONCLUSIONS: Long-term mortality among sepsis survivors remains high, with more than 40% dying within 2 years after hospital discharge. These findings support the need for structured post-sepsis care strategies focused on high-risk patients, improved continuity of care, and prevention of long-term sepsis-related complications.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.