Understanding Post-Sepsis Syndrome: How Can Clinicians Help?

Abstract

Sepsis is a global health challenge, with over 49 million cases annually. Recent medical advancements have increased in-hospital survival rates to approximately 80%, but the escalating incidence of sepsis, owing to an ageing population, rise in chronic diseases, and antibiotic resistance, have also increased the number of sepsis survivors. Subsequently, there is a growing prevalence of “post-sepsis syndrome” (PSS). This syndrome includes long-term physical, medical, cognitive, and psychological issues after recovering from sepsis. PSS puts survivors at risk for hospital readmission and is associated with a reduction in health- and life span, both at short and long term, after hospital discharge. Comprehensive understanding of PSS symptoms and causative factors is vital for developing optimal care for sepsis survivors, a task of prime importance for clinicians. This review aims to elucidate our current knowledge of PSS and its relevance in enhancing post-sepsis care provided by clinicians.

The critically ill older patient with sepsis: a narrative review

“…Post-intensive care syndrome (PICS) symptoms, prevalent among older sepsis survivors, include muscle weakness, fatigue, cognitive decline, sleep disturbances, emotional distress, and swallowing problems [ 125 , 136 , 137 ]. Another term, possibly more specific, is post-sepsis syndrome (PSS) [ 138 ]. Factors such as pre-existing co-morbidity and frailty, polypharmacy, delirium during hospitalization and injury induced by sepsis [ 134 , 138 ] can exacerbate outcomes.…”

“…Another term, possibly more specific, is post-sepsis syndrome (PSS) [ 138 ]. Factors such as pre-existing co-morbidity and frailty, polypharmacy, delirium during hospitalization and injury induced by sepsis [ 134 , 138 ] can exacerbate outcomes.…”

Hospital Acquired Sepsis, Disease Prevalence, and Recent Advances in Sepsis Mitigation

“…Importantly, however, ca. 75% of patients who have recovered from sepsis have higher rates of long-term morbidities, including mental health issues, cognitive difficulties, physical issues, and mortalities post discharge, termed “post-sepsis syndrome” (PSS) [ 14 , 15 ]. Sepsis recovery patients are therefore at an increased risk of re-hospitalisation, chronic illness, co-morbidities, organ damage/failure (kidney, heart and respiratory) and have a reduced life expectancy [ 16 ].…”

Restoring the infected powerhouse: Mitochondrial quality control in sepsis

“…There is a long-established recognition that the host response, rather than the pathogen itself, is responsible for much of the tissue damage observed in sepsis [ 6 , 8 , 11 ]. In particular, the hyperinflammatory response that can occur in sepsis can lead to widespread tissue damage and organ failure [ 6 , 8 , 12 ], exposing sepsis survivors increased all-cause mortality risk as well as functional and cognitive impairments [ 13 , 14 ]. Additionally, mitochondrial dysfunction is considered to play a key role in the induction of organ damage and failure in sepsis [ 15 ].…”