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Evidence for a causal link between sepsis and long-term mortality: a systematic review of epidemiologic studies

Overview of attention for article published in Critical Care, April 2016
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • Above-average Attention Score compared to outputs of the same age and source (61st percentile)

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47 X users
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180 Mendeley
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Title
Evidence for a causal link between sepsis and long-term mortality: a systematic review of epidemiologic studies
Published in
Critical Care, April 2016
DOI 10.1186/s13054-016-1276-7
Pubmed ID
Authors

Manu Shankar-Hari, Michael Ambler, Viyaasan Mahalingasivam, Andrew Jones, Kathryn Rowan, Gordon D. Rubenfeld

Abstract

In addition to acute hospital mortality, sepsis is associated with higher risk of death following hospital discharge. We assessed the strength of epidemiological evidence supporting a causal link between sepsis and mortality after hospital discharge by systematically evaluating the available literature for strength of association, bias, and techniques to address confounding. We searched Medline and Embase using the following 'mp' terms, MESH headings and combinations thereof - sepsis, septic shock, septicemia, outcome. Studies published since 1992 where one-year post-acute mortality in adult survivors of acute sepsis could be calculated were included. Two authors independently selected studies and extracted data using predefined criteria and data extraction forms to assess risk of bias, confounding, and causality. The difference in proportion between cumulative one-year mortality and acute mortality was defined as post-acute mortality. Meta-analysis was done by sepsis definition categories with post-acute mortality as the primary outcome. The literature search identified 11,156 records, of which 59 studies met our inclusion criteria and 43 studies reported post-acute mortality. In patients who survived an index sepsis admission, the post-acute mortality was 16.1 % (95 % CI 14.1, 18.1 %) with significant heterogeneity (p < 0.001), on random effects meta-analysis. In studies reporting non-sepsis control arm comparisons, sepsis was not consistently associated with a higher hazard ratio for post-acute mortality. The additional hazard associated with sepsis was greatest when compared to the general population. Older age, male sex, and presence of comorbidities were commonly reported independent predictors of post-acute mortality in sepsis survivors, challenging the causality relationship. Sensitivity analyses for post-acute mortality were consistent with primary analysis. Epidemiologic criteria for a causal relationship between sepsis and post-acute mortality were not consistently observed. Additional epidemiologic studies with recent patient level data that address the pre-illness trajectory, confounding, and varying control groups are needed to estimate sepsis-attributable additional risk and modifiable risk factors to design interventional trials.

X Demographics

X Demographics

The data shown below were collected from the profiles of 47 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 180 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 <1%
Russia 1 <1%
Unknown 178 99%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 25 14%
Student > Master 22 12%
Researcher 21 12%
Student > Bachelor 15 8%
Other 12 7%
Other 43 24%
Unknown 42 23%
Readers by discipline Count As %
Medicine and Dentistry 74 41%
Nursing and Health Professions 17 9%
Agricultural and Biological Sciences 7 4%
Biochemistry, Genetics and Molecular Biology 7 4%
Neuroscience 5 3%
Other 23 13%
Unknown 47 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 27. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 February 2020.
All research outputs
#1,415,371
of 25,420,980 outputs
Outputs from Critical Care
#1,231
of 6,562 outputs
Outputs of similar age
#23,814
of 315,881 outputs
Outputs of similar age from Critical Care
#40
of 100 outputs
Altmetric has tracked 25,420,980 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 94th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,562 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.8. This one has done well, scoring higher than 81% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 315,881 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 100 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.