Quality of life after septic illness

Lazosky, Andrea; Young, G. Bryan; Zirul, Sandra; Phillips, Reneé

doi:10.1016/j.jcrc.2009.10.001

Cited by 45 publications

(40 citation statements)

References 25 publications

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“…Recently global cognitive impairment was found in 17% of a large older cohort of sepsis survivors 8 years post illness, with significant associated functional impairments as well 5. A recent self-report based study of quality of life has pointed to difficulties with sensory processing, emotional functioning, concentration and memory in the 1–4 years following sepsis in a small cohort of eight patients 9. Lowered quality of life in sepsis patients has been verified by this and several other previous studies 10–13.…”

Section: Introductionmentioning

confidence: 99%

“…Lowered quality of life in sepsis patients has been verified by this and several other previous studies 10–13. Although much effort has been made to study long-term cognitive consequences of acute respiratory distress syndrome,14 a related but distinct syndrome, and of critical illness in general,15 16 to our knowledge Iwashyna et al 5 and Lazosky et al 9 have provided the only direct examinations of cognitive change specifically as a result of sepsis to date. Specific inferences about which domains are affected could not be made in the former study, and other events occurring in the long period before follow-up (in particular, aging) could have accounted for impairments found.…”

Section: Introductionmentioning

confidence: 99%

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Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors

Semmler

Widmann

Okulla

et al. 2012

J Neurol Neurosurg Psychiatry

239

183

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors

Semmler

Widmann

Okulla

et al. 2012

J Neurol Neurosurg Psychiatry

239

183

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“…Both developing and mature neurons and glia possess numerous pro-inflammatory cytokine receptors, which make them susceptible to inflammation-assocaited damage [14] . The neuroinflammatory response was reported to occur with weight loss [15,16] , neurodegeneration [17] , white matter damage [18], and cognitive and affective disorder [19] . Since LPS can reproduce many of the neuroinflammatory complications, it has been considered as the most established animal model for investigating the impact of bacterial-induced neuroinflammation [12,17,20] .…”

mentioning

confidence: 99%

Neonatal Lipopolysaccharide Infection Causes Demyelination and Behavioral Deficits in Adult and Senile Rat Brain

2017

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Background: Neonatal bacterial infections have been reported to cause white matter loss, although studies concerning the influence of infection on the expression of myelin and aging are still in their emerging state. Purpose: The present study aimed to investigate the effects of perinatal lipopolysaccharide (LPS) exposure on the myelination at different age points using histochemical and immunocytochemical techniques and the relative motor coordination. Methods: A rat bacterial infection model was established by exposing the neonatal rats with LPS (0.3 mg/kg body weight, i.p., on postnatal day (PND) 3 followed by a booster at PND 5) and its impact was studied on the myelination and motor coordination in young, adult, and senile rats. Results: The results obtained suggest that the administration of LPS induces demyelination, predominantly in cortex and corpus callosum. Low expression level of myelin oligodendrocyte glycoprotein (MOG) was observed at all time points, with prominence at 12, 18, and 24 months of age. In addition, reduced staining with luxol fast blue stain was also recorded in the experimentals. With the increasing demyelination and declining motor ability, LPS exposure also seemed to accelerate normal aging symptoms. Conclusion: There is a direct correlation of myelin damage and poor motor coordination with age. This would provide a better incite to understand inflammation-associated demyelinating changes in age-associated neurodegenerative disorders. Since, no long-term studies on behavioral impairments caused by LPS-induced demyelination in the central nervous system has been reported so far, this work would help in the better understanding of the long-term pathological effects of bacterial-induced demyelination.

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“…This looked at estimated life expectancy of all survivors and the likely cost to gain one additional year of living in perfect health (1 quality‐adjusted life‐year, QALY). To determine the QALY value, the remaining life expectancy for each surviving patient was calculated20, and a utility value was assigned to various stages of the disease process21, 22, 23. For example, if an individual has a life expectancy of 7 years, and the QALY value is 0·66 for the first year after operation, 0·71 for the second and third years, and 0·75 for the last 4 years, the adjusted life expectancy is 5·08 years (1*0·66 + 2*0·71 + 4*0·75).…”

Section: Methodsmentioning

confidence: 99%

“…Long‐term effects were calculated by extrapolating the results using external evidence on utility and risk of death after survival in the ICU21, 22, 23, 24, 25, 26. A predictive modelling technique was then applied.…”

Section: Methodsmentioning

confidence: 99%

Cost‐effectiveness of a quality improvement bundle for emergency laparotomy

Ebm¹,

Aggarwal

Huddart

et al. 2018

BJS Open

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BackgroundThe recent Emergency Laparotomy Pathway Quality Improvement Care (ELPQuiC) study showed that the use of a specific care bundle reduced mortality in patients undergoing emergency laparotomy. However, the costs of implementation of the ELPQuiC bundle remain unknown. The aim of this study was to assess the in‐hospital and societal costs of implementing the ELPQuiC bundle.MethodsThe ELPQuiC study employed a before–after approach using quality improvement methodology. To assess the costs and cost‐effectiveness of the bundle, two models were constructed: a short‐term model to assess in‐hospital costs and a long‐term model (societal decision tree) to evaluate the patient's lifetime costs (in euros).ResultsUsing health economic modelling and data collected from the ELPQuiC study, estimated costs for initial implementation of the ELPQuiC bundle were €30 026·11 (range 1794·64–40 784·06) per hospital. In‐hospital costs per patient were estimated at €14 817·24 for standard (non‐care bundle) treatment versus €15 971·24 for the ELPQuiC bundle treatment. Taking a societal perspective, lifetime costs of the patient in the standard group were €23 058·87, compared with €19 102·37 for patients receiving the ELPQuiC bundle. The increased life expectancy of 4 months for patients treated with the ELPQuiC bundle was associated with cost savings of €11 410·38 per quality‐adjusted life‐year saved.ConclusionImplementation of the ELPQuiC bundle is associated with lower mortality and higher in‐hospital costs but reduced societal costs.

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Quality of life after septic illness

Cited by 45 publications

References 25 publications

Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors

Persistent cognitive impairment, hippocampal atrophy and EEG changes in sepsis survivors

Neonatal Lipopolysaccharide Infection Causes Demyelination and Behavioral Deficits in Adult and Senile Rat Brain

Cost‐effectiveness of a quality improvement bundle for emergency laparotomy

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