Interplay between sepsis and chronic health

Abstract

Severe sepsis is associated with high short-term mortality. Several studies suggest that severe sepsis also worsens health status and increases disability among survivors. As the incidence of severe sepsis increases, and advances in critical care reduce the short-term mortality, the number of individuals who are at risk for poor long-term outcomes will increase. Recent studies suggest that the relationship between sepsis and chronic health may be bidirectional; however, the mechanisms underlying this relationship remain poorly understood. Here we review the epidemiologic studies examining the interplay between sepsis and chronic health and propose a conceptual model, which has implications for preclinical and human study design.

Figure 1

Conceptual model describing chronic health status before and during sepsis and the trajectories of health during recovery. A denotes health status trajectory prior to sepsis. B denotes the health status during the acute phase. Health status often worsens during this phase due to organ dysfunction. C denotes trajectories during recovery. These include no change in trajectory compared to A (C1), slow progressive worsening (C2), relapsing (C3), and rapidly progressive (C4) health status.