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Am J Crit Care. 2019 Nov;28(6):424-432. doi: 10.4037/ajcc2019638.

Effects of Sepsis on Morbidity and Mortality in Critically Ill Patients 2 Years After Intensive Care Unit Discharge.

Author information

1
Livia Biason is a research medical doctor in the postgraduate program of respiratory sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil. Cassiano Teixeira is a professor in the Department of Internal Medicine and postgraduate program of rehabilitation science, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil, and a staff intensivist in the Department of Critical Care, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. Jaqueline Sangiogo Haas is a staff nurse in the Department of Critical Care, Hospital de Clínicas de Porto Alegre. Cláudia da Rocha Cabral is a research nurse at the Universidade do Vale do Rio dos Sinos. Gilberto Friedman is a professor in the postgraduate program in respiratory sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, and a professor in the Department of Critical Care, Hospital de Clínicas de Porto Alegre.
2
Livia Biason is a research medical doctor in the postgraduate program of respiratory sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil. Cassiano Teixeira is a professor in the Department of Internal Medicine and postgraduate program of rehabilitation science, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil, and a staff intensivist in the Department of Critical Care, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. Jaqueline Sangiogo Haas is a staff nurse in the Department of Critical Care, Hospital de Clínicas de Porto Alegre. Cláudia da Rocha Cabral is a research nurse at the Universidade do Vale do Rio dos Sinos. Gilberto Friedman is a professor in the postgraduate program in respiratory sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, and a professor in the Department of Critical Care, Hospital de Clínicas de Porto Alegre. gfriedman@hcpa.edu.br.

Abstract

BACKGROUND:

Morbidity and mortality after discharge from an intensive care unit appear to be higher in patients with sepsis than in patients without sepsis.

OBJECTIVE:

To evaluate morbidity and mortality in patients with and without sepsis within 2 years after intensive care unit discharge.

METHODS:

A prospective cohort study was conducted in 2 intensive care units. Patients who stayed in the intensive care unit longer than 24 hours were followed up for 2 years after discharge. Morbidity was assessed by using the Karnofsky scale, the Lawton instrumental activities of daily living scale, presence of pain, and readmissions.

RESULTS:

During the study, 74.7% of patients (859 of 1150; 242 with sepsis, 617 without sepsis) were discharged from the intensive care unit. Compared with patients without sepsis, patients with sepsis had higher mortality during follow-up (57.4% vs 34.2%; P < .001) and were 1.34 times as likely to die (per Cox regression). More patients with sepsis had pain (48.5% vs 35.2%, P = .003) and read-missions (65.5% vs 55.0%, P = .02). Patients with sepsis had a greater degree of functional loss, adjusted for confounding factors (mean [SD] change in Lawton scale score from intensive care unit admission to 2 years after intensive care unit discharge, 4.0 [8.0] vs 3.4 [8.2]; P = .31).

CONCLUSION:

Compared with patients without sepsis, those with sepsis have higher mortality in the intensive care unit and have more pain, hospital readmissions, and functional decline within 2 years after discharge.

PMID:
31676516
DOI:
10.4037/ajcc2019638

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