Abstract Introduction Septic shock remains a leading cause of critical illness and healthcare expenditure in the United States. Although most epidemiologic data focus on older adults, the burden and outcomes of septic shock in younger populations are not well described. Understanding mortality patterns, resource utilization, and post-discharge outcomes in this subgroup may inform early recognition and long-term support strategies. Methods We performed a retrospective cohort analysis using the 2022 Nationwide Readmissions Database (NRD) to describe outcomes among adult hospitalizations (≥18 years) with septic shock, identified using ICD-10-CM codes. Young adults were defined as patients aged ≤40 years. Primary outcomes included in-hospital all-cause mortality and use of advanced critical care interventions—mechanical ventilation (IMV), continuous renal replacement therapy (CRRT), and veno-venous extracorporeal membrane oxygenation (VV-ECMO). Secondary outcomes included hospital length of stay (LOS), total hospitalization costs, and discharge disposition. Descriptive statistics were summarized as means for continuous variables and proportions for categorical variables Results The total number of septic shock admissions in NRD 2022 was 702, 766, of which 48, 584 (6. 9%) occurred in young adults aged ≤40 years. The mean age in this group was 32 years, with 48% of the participants being female. Medicaid was the primary payer in 51. 5%, followed by private insurance (27. 9%) and Medicare (14. 0%), indicating a socioeconomically vulnerable population. Despite their age, outcomes were poor: in-hospital mortality was 23. 2%, meaning nearly one in four young septic shock adults died during hospitalization. A significant age-related mortality gradient was observed, with predicted mortality rising from ≈11. 6% at age 18 to 26. 9% at age 40 (p 0. 001). Advanced critical care support was frequent—IMV 49. 6%, CRRT 9. 6%, and VV-ECMO 2. 0%. The mean LOS was 18. 9 days, and average total charges exceeded 350, 000, reflecting high-intensity care. Among survivors, 31. 9% were discharged to post-acute care facilities, reflecting significant functional impairment and ongoing care needs. Conclusion Our study showed that septic shock in young adults carries an unexpectedly high mortality and resource burden, with frequent dependence on advanced organ support and substantial post-discharge disability. Although mortality in older adults remains higher overall, the magnitude of poor outcomes in this younger, economically productive population is striking and clinically consequential. These findings challenge the perception that youth confers protection from severe sepsis and underscore the need for age-conscious sepsis pathways, timely escalation protocols, and post-ICU recovery policies to mitigate the long-term societal and economic impact. This abstract is funded by: None
Khan et al. (Fri,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: