| Spurious inferences about long-term outcomes: the case of severe sepsis and geriatric conditions. | |
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MedLine Citation:
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PMID: 22323301 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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RATIONALE: Survivors of critical illness suffer significant limitations and disabilities. OBJECTIVES: Ascertain whether severe sepsis is associated with increased risk of so-called geriatric conditions (injurious falls, low body mass index [BMI], incontinence, vision loss, hearing loss, and chronic pain) and whether this association is measured consistently across three different study designs. METHODS: Patients with severe sepsis were identified in the Health and Retirement Study, a nationally representative cohort interviewed every 2 years, 1998 to 2006, and in linked Medicare claims. Three comparators were used to assess an association of severe sepsis with geriatric conditions in survivors: the prevalence in the United States population aged 65 years and older, survivors' own pre-sepsis levels assessed before hospitalization, or survivors' own pre-sepsis trajectory. MEASUREMENTS AND MAIN RESULTS: Six hundred twenty-three severe sepsis hospitalizations were followed a median of 0.92 years. When compared with the 65 years and older population, surviving severe sepsis was associated with increased rates of low BMI, injurious falls, incontinence, and vision loss. Results were similar when comparing survivors to their own pre-sepsis levels. The association of low BMI and severe sepsis persisted when controlling for patients' pre-sepsis trajectories, but there was no association of severe sepsis with injurious falls, incontinence, vision loss, hearing loss, and chronic pain after such controls. CONCLUSIONS: Geriatric conditions are common after severe sepsis. However, severe sepsis is associated with increased rates of only a subset of geriatric conditions, not all. In studying outcomes after acute illness, failing to measure and control for both preillness levels and trajectories may result in erroneous conclusions. |
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Authors:
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Theodore J Iwashyna; Giora Netzer; Kenneth M Langa; Christine Cigolle |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. Date: 2012-02-09 |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: 185 ISSN: 1535-4970 ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-04-16 Completed Date: 2012-06-01 Revised Date: 2013-04-15 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 835-41 Citation Subset: AIM; IM |
Affiliation:
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Department of Medicine, University of Michigan, Ann Arbor, USA. tiwashyn@umich.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Body Mass Index Chronic Pain / epidemiology Cohort Studies Comorbidity Critical Illness / mortality, therapy Disabled Persons / statistics & numerical data* Disease Progression Female Geriatric Assessment* Hearing Disorders / diagnosis, epidemiology Hospitalization / statistics & numerical data Humans Incidence Male Musculoskeletal Diseases / diagnosis, epidemiology Prognosis Retrospective Studies Risk Assessment Sepsis / diagnosis*, epidemiology*, therapy Survival Analysis Survivors / statistics & numerical data Thinness / epidemiology Time Treatment Outcome Urinary Incontinence / diagnosis, epidemiology Vision Disorders / diagnosis, epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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K08 AG031837/AG/NIA NIH HHS; K08 AG031837/AG/NIA NIH HHS; K08 HL091249/HL/NHLBI NIH HHS; K12 RR023250/RR/NCRR NIH HHS; P30-AG028747/AG/NIA NIH HHS; P60 DK-20572/DK/NIDDK NIH HHS; R01 AG030155/AG/NIA NIH HHS; U01 AG09740/AG/NIA NIH HHS; UL1RR024986/RR/NCRR NIH HHS |
| Comments/Corrections | |
Comment In:
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Am J Respir Crit Care Med. 2012 Apr 15;185(8):796-8
[PMID:
22505749
]
Am J Respir Crit Care Med. 2012 Aug 1;186(3):290; author reply 290-1 [PMID: 22855544 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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