The long-term burden of severe sepsis and septic shock: Sepsis recidivism and organ dysfunction.

Background: Severe sepsis and septic shock mortality has improved, however rates of persistent (28 to 90 day) and long-term (>90 day) organ dysfunction in sepsis survivors are unknown. Methods: Secondary analysis of a prospective cohort of adult Emergency Department patients with severe sepsis. Results: Of 110 sepsis admissions, we obtained follow up on 51 of 78 survivors of whom 41% (21/51) had persistent organ dysfunction: pulmonary 18% (9/51), renal 22% (11/51), coagulopathy 10% (5/51), cardiovascular 6% (3/51), hepatic 2% (1/51), and neurologic 3% (3/51). We obtained follow up on 40 of 73 survivors at >90 days of whom 38% (15/40) had long-term organ dysfunction: pulmonary 13% (5/40), renal 18% (7/40), coagulopathy 3% (1/40), cardiovascular 5% (2/40), hepatic 0%, and neurologic 5% (2/40). Readmission rate within 90 days was 32% (25/78) and recurrent sepsis was the cause of readmission in 52% (13/25). Baseline SOFA scores from the index sepsis admission were compared using Wilcoxon's rank-sum test and were significantly different in participants with vs without organ dysfunction at

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