Long-term mortality and quality of life in sepsis: A systematic review*

Abstract

Patients with sepsis have ongoing mortality beyond short-term end points, and survivors consistently demonstrate impaired quality of life. The use of 28-day mortality as an end point for clinical studies may lead to inaccurate inferences. Both observational and interventional future studies should include longer-term end points to better-understand the natural history of sepsis and the effect of interventions on patient morbidities.

Sepsis induces Telomere Shortening: a Potential Mechanism Responsible for Delayed Pathophysiological Events in Sepsis Survivors?

“…In addition to the existing interest in therapeutic approaches for sepsis (where therapy remains supportive and no specific treatments have been identified, even after decades of intensive research), there is also an increasing interest in approaches to improve the health of sepsis survivors (27,32). Molecular Medicine…”

Inflammatory responses predict long-term mortality risk in community-acquired pneumonia

“…Previous studies have investigated long-term sequelae of CAP [16,[19][20][21][22]. JOHNSTONE et al [16] recently investigated longterm morbidity and mortality of patients with CAP requiring hospitalisation using multiple linked administrative databases in Canada after a median follow-up of 3.8 yrs.…”

“…However, less extensive research has been conducted for a better understanding of factors influencing longterm mortality after initial hospitalisation of CAP patients. Previous data suggest that patients who survive an initial CAP episode are at increased risk of mortality and recurrent infections in the months following hospital discharge [16][17][18][19][20][21][22], especially in patients .40 yrs of age [23]. CAP may be a consequence of a patient's poor general condition and severe underlying comorbidities, which place patients at risk of further infections and mortality [18].…”

Spurious Inferences about Long-Term Outcomes

“…For example, survivors of acute respiratory distress syndrome (ARDS) have prolonged 6-minute walk times, executive dysfunction, other neuropsychiatric deficits, and diminished ability to return to work (2-13). Numerous studies have found quality of life among survivors of critical illness (14, 15), severe sepsis (16,17), and ARDS (4-8, 13, 18) to be abnormally low.Patients surviving critical illness have limitations and disabilities somewhat characteristic of an older adult population. Rubenfeld recently postulated a "progeric hypothesis" that the sequelae of critical illness mirror accelerated aging (19).…”

“…For example, survivors of acute respiratory distress syndrome (ARDS) have prolonged 6-minute walk times, executive dysfunction, other neuropsychiatric deficits, and diminished ability to return to work (2-13). Numerous studies have found quality of life among survivors of critical illness (14, 15), severe sepsis (16,17), and ARDS (4-8, 13, 18) to be abnormally low.…”