Prevalence and Long-Term Prognosis of Post-Intensive Care Syndrome after Sepsis: A Single-Center Prospective Observational Study

Abstract

Post-intensive care syndrome (PICS) comprises physical, mental, and cognitive disorders following a severe illness. The impact of PICS on long-term prognosis has not been fully investigated. This study aimed to: (1) clarify the frequency and clinical characteristics of PICS in sepsis patients and (2) explore the relationship between PICS occurrence and 2-year survival. Patients with sepsis admitted to intensive care unit were enrolled. Data on patient background; clinical information since admission; physical, mental, and cognitive impairments at 3-, 6-, and 12-months post-sepsis onset; 2-year survival; and cause of death were obtained from electronic medical records and telephonic interviews with patients and their families. At 3 months, comparisons of variables were undertaken in the PICS group and the non-PICS group. Among the 77 participants, the in-hospital mortality rate was 11% and the 2-year mortality rate was 52%. The frequencies of PICS at 3, 6, and 12 months were 70%, 60%, and 35%, respectively. The 2-year survival was lower in the PICS group than in the non-PICS group (54% vs. 94%, p < 0.01). More than half of the survivors had PICS at 3 and 6 months after sepsis. Among survivors with sepsis, those who developed PICS after 3 months had a lower 2-year survival.

Cognitive impairment is a risk factor for long-term outcomes in septic patients: A retrospective observational study

“…Post- intensive care syndrome (PICS) has recently received considerable attention and could be a prominent example of such factors. A single-center prospective study conducted in Japan found that 70% of patients experienced PICS three months after contracting sepsis [20]. The study identified Glasgow coma scale (GCS) on day 7 as an independent, reliable marker for PICS, rather than any variables related to sepsis.…”

Post‐intensive care syndrome: Recent advances and future directions

“…The incidence rate of PICS has been reported to be 50%–70% at 6 months following ICU discharge. 12 , 65 Based on the combined data of our study and an integrated analysis of diagnostic procedure 5 , 66 in Japan, the annual number of patients with PICS following sepsis is thought to be approximately 420,000. Furthermore, PICS at 3 months was related to the significant increase in 2‐year mortality in patients with sepsis, addressing the profound impact of PICS on the long‐term mortality of patients in the ICU.…”

“…Furthermore, PICS at 3 months was related to the significant increase in 2‐year mortality in patients with sepsis, addressing the profound impact of PICS on the long‐term mortality of patients in the ICU. 66 …”

The chain of survival and rehabilitation for sepsis: concepts and proposals for healthcare trajectory optimization

“…The “post-sepsis syndrome (PSS)” associates physical, medical, cognitive, and mental health sequalae, responsible of long-term morbidity [ 16 ]. Prior to PSS, the post-intensive care syndrome (PICS) involves physical, cognitive, and mental impairments occurring during ICU stay or after ICU/hospital discharge, impairing the long-term outcome of survivors [ 94 – 98 ]. In order to combat PSS and PICS, post discharge rehabilitation strategies are effective and associated with a reduced risk of 10-year mortality in sepsis survivors [ 99 ].…”