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

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.