Long-term outcomes of patients with toxic shock syndrome: A matched cohort study

Objectives

We examined long-term outcomes of toxic shock syndrome.

Methods

We conducted a matched cohort study of 630 patients with toxic shock syndrome and 5009 healthy controls between 2006 and 2021 in Quebec, Canada. Outcomes included hospitalization for renal, cardiovascular, hepatic, and other morbidity during 15 years of follow-up. We estimated adjusted hazard ratios (HR) and 95% confidence intervals (CI) for the risk of these outcomes over time, comparing patients with toxic shock syndrome relative to matched controls.

Results

Compared with healthy controls, rehospitalization rates at 15 years were higher for men with toxic shock syndrome (52.0 vs 30.0 per 100) but not for women (38.7 vs 45.6 per 100). In men, toxic shock syndrome was associated with an elevated risk of renal (HR 17.43, 95% CI 6.35–47.82), cardiovascular (HR 2.57; 95% CI 1.52–4.34), and hepatic hospitalization (HR 19.83, 95% CI 4.72–83.34). In women, toxic shock syndrome was associated with renal hospitalization (HR 4.71, 95% CI 1.94–11.45). Streptococcal toxic shock was associated with a greater risk of rehospitalization than staphylococcal toxic shock.

Conclusions

Toxic shock syndrome is associated with rehospitalization up to 15 years later, especially in men. These patients may benefit from continued follow-up to prevent long-term morbidity.