EFFECTS OF SEPSIS ON MORBIDITY AND MORTALITY IN CRITICALLY ILL PATIENTS 2 YEARS AFTER INTENSIVE CARE UNIT DISCHARGE

被引:10
作者
Biason, Livia [1 ]
Teixeira, Cassiano [2 ,3 ,4 ]
Haas, Jaqueline Sangiogo [4 ]
Cabral, Claudia da Rocha [5 ]
Friedman, Gilberto [1 ,4 ]
机构
[1] Univ Fed Rio Grande do Sul, Postgrad Program Resp Sci, Sch Med, Porto Alegre, RS, Brazil
[2] Univ Fed Ciencias Saude Porto Alegre, Sch Med, Dept Internal Med, Porto Alegre, RS, Brazil
[3] Univ Fed Ciencias Saude Porto Alegre, Sch Med, Postgrad Program Rehabil Sci, Porto Alegre, RS, Brazil
[4] Hosp Clin Porto Alegre, Dept Crit Care, Porto Alegre, RS, Brazil
[5] Univ Vale Rio dos Sinos, Sao Leopoldo, RS, Brazil
关键词
QUALITY-OF-LIFE; LONG-TERM MORTALITY; SEPTIC SHOCK; OLDER-PEOPLE; FOLLOW-UP; SURVIVORS; EPIDEMIOLOGY; RECOVERY; OUTCOMES;
D O I
10.4037/ajcc2019638
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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 readmissions (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.
引用
收藏
页码:424 / 432
页数:9
相关论文
共 40 条
[1]   Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care [J].
Angus, DC ;
Linde-Zwirble, WT ;
Lidicker, J ;
Clermont, G ;
Carcillo, J ;
Pinsky, MR .
CRITICAL CARE MEDICINE, 2001, 29 (07) :1303-1310
[2]  
[Anonymous], CRIT CARE S1
[3]   Long Term Health-Related Quality of Life in Survivors of Sepsis in South West Wales: An Epidemiological Study [J].
Battle, Ceri E. ;
Davies, Gareth ;
Evans, Phillip A. .
PLOS ONE, 2014, 9 (12)
[4]   Chronic pain in survivors of critical illness: a retrospective analysis of incidence and risk factors [J].
Battle, Ceri E. ;
Lovett, Simon ;
Hutchings, Hayley .
CRITICAL CARE, 2013, 17 (03)
[5]   Prevalence and Characteristics of Chronic Intensive Care-Related Pain: The Role of Severe Sepsis and Septic Shock [J].
Baumbach, Philipp ;
Goetz, Theresa ;
Guenther, Albrecht ;
Weiss, Thomas ;
Meissner, Winfried .
CRITICAL CARE MEDICINE, 2016, 44 (06) :1129-1137
[6]  
DELLINGER RP, 2013, INTENS CARE MED, V39, P165, DOI DOI 10.1007/s00134-012-2769-8
[7]   Characteristics and Outcomes of Intensive Care Unit Survivors: Experience of a Multidisciplinary Outpatient Clinic in a Teaching Hospital [J].
Duarte, Pericles A. D. ;
Costa, Jaquilene Barreto ;
Duarte, Silvana Trilo ;
Taba, Sheila ;
Felicetti Lordani, Claudia Regina ;
Osaku, Erica Fernanda ;
Lima Macedo Costa, Claudia Rejane ;
Miglioranza, Dalas Cristina ;
Gund, Daniela Prochnow ;
Jorge, Amaury Cesar .
CLINICS, 2017, 72 (12) :764-772
[8]   ICU-recovery in Scandinavia: A comparative study of intensive care follow-up in Denmark, Norway and Sweden [J].
Egerod, Ingrid ;
Risom, Signe S. ;
Thomsen, Thordis ;
Storli, Sissel L. ;
Eskerud, Ragne S. ;
Holme, Anny N. ;
Samuelson, Karin A. M. .
INTENSIVE AND CRITICAL CARE NURSING, 2013, 29 (02) :103-111
[9]   Organizational Issues, Structure, and Processes of Care in 257 ICUs in Latin America: A Study From the Latin America Intensive Care Network [J].
Estenssoro, Elisa ;
Alegria, Leyla ;
Murias, Gaston ;
Friedman, Gilberto ;
Castro, Ricardo ;
Vaeza, Nicolas Nin ;
Loudet, Cecilia ;
Bruhn, Alejandro ;
Jibaja, Manuel ;
Ospina-Tascon, Gustavo ;
Rios, Fernando ;
Machado, Flavia R. ;
Cavalcanti, Alexandre Biasi ;
Dubin, Arnaldo ;
Hurtado, F. Javier ;
Briva, Arturo ;
Romero, Carlos ;
Bugedo, Guillermo ;
Bakker, Jan ;
Cecconi, Maurizio ;
Azevedo, Luciano ;
Hernandez, Glenn .
CRITICAL CARE MEDICINE, 2017, 45 (08) :1325-1336
[10]  
Finfer S, 2016, AM J RESP CRIT CARE, V193, P228, DOI 10.1164/rccm.201510-1976ED