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. 2025 May 1;13(1):23.
doi: 10.1186/s40560-025-00792-0.

One-year outcomes in sepsis: a prospective multicenter cohort study in Japan

Keibun Liu #  1   2 , Shinichi Watanabe #  3   4 , Kensuke Nakamura  5   6 , Hidehiko Nakano  6 , Maiko Motoki  6 , Hiroshi Kamijo  7 , Matsuoka Ayaka  8 , Kenzo Ishii  9 , Yasunari Morita  10 , Takashi Hongo  11   12 , Nobutake Shimojo  13 , Yukiko Tanaka  14 , Manabu Hanazawa  15 , Tomohiro Hamagami  16 , Kenji Oike  17 , Daisuke Kasugai  18 , Yutaka Sakuda  19 , Yuhei Irie  20 , Masakazu Nitta  21 , Kazuki Akieda  22 , Daigo Shimakura  23 , Hajime Katsukawa  24 , Toru Kotani  25 , David McWilliams  26   27 , Peter Nydahl  28   29 , Stefan J Schaller  30   31 , Takayuki Ogura  32 ; ILOSS Study Group
Affiliations

One-year outcomes in sepsis: a prospective multicenter cohort study in Japan

Keibun Liu et al. J Intensive Care. .

Erratum in

  • Correction: One-year outcomes in sepsis: a prospective multicenter cohort study in Japan.
    Liu K, Watanabe S, Nakamura K, Nakano H, Motoki M, Kamijo H, Ayaka M, Ishii K, Morita Y, Hongo T, Shimojo N, Tanaka Y, Hanazawa M, Hamagami T, Oike K, Kasugai D, Sakuda Y, Irie Y, Nitta M, Akieda K, Shimakura D, Katsukawa H, Kotani T, McWilliams D, Nydahl P, Schaller SJ, Ogura T; ILOSS Study Group. Liu K, et al. J Intensive Care. 2025 May 22;13(1):28. doi: 10.1186/s40560-025-00799-7. J Intensive Care. 2025. PMID: 40405308 Free PMC article. No abstract available.

Abstract

Background: Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions.

Methods: A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up.

Results: A total of 339 patients were included (median age 74 [67-82] years, 60% male, 77% septic shock, and a median SOFA of 9 [6-12]). Mortality was 23% at hospital discharge, increasing to 37% at 12 months. The rate of death for those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44%), high rates of hospital readmissions (40%), frequent emergency service usage (31%), and low utilization of rehabilitation and psychiatric services (15% and 7%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups.

Conclusions: This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433.

Keywords: Intensive care unit; Morbidity; Mortality; Post-intensive care syndrome; Quality of life; Sepsis.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study received ethics approvals from Saiseikai Utsunomiya Hospital (2020–42) and all other participating institutions. It was registered in the University Hospital Medical Information Network Clinical Trials Registry (Trial registration number: UMIN 000041433), and informed consent was obtained from all patients. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient flow chart. COVID-19: Coronavirus disease 2019, ICU Intensive Care Unit
Fig. 2
Fig. 2
Primary outcome of the death or incidence of PICS. PICS Post Intensive Care Syndrome
See this image and copyright information in PMC

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