Fig. 1.

PICO summary and approach to research question. The principal exposure was surviving an index sepsis-related hospitalisation (sepsis survivors). The outcome of interest was all-cause rehospitalisation, which will be affected by a survivorship bias in the observed associations, as sepsis survivors are likely to be healthier than patients who die during the sepsis-related hospitalisation and b bias from competing risk as sepsis survivors also have a long-term risk of mortality. Shorter follow-up times in rehospitalisation studies preclude observation of outcome of interest (i.e., censored outcomes). A = Sepsis cohort starting from their index admission which may have greater risk of survivorship bias; B = Ideal cohort to address the research question; and C = Re-hospitalised survivor cohort all patients have the outcome of interest and there is limited understanding of the competing risk issue. Studies with non-sepsis controls provide an estimate the excess risk of rehospitalisation that is unique to sepsis [10, 87]