The DOI matches its Crossref record; 93 of the 93 references it cites were found in a registry or an index.
Enhancing Recovery From Sepsis: A Review
Open accessAbstract
Importance: Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Observations: Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments. Impairments include development of an average of 1 to 2 new functional limitations (eg, inability to bathe or dress independently), a 3-fold increase in prevalence of moderate to severe cognitive impairment (from 6.1% before hospitalization to 16.7% after hospitalization), and a high prevalence of mental health problems, including anxiety (32% of patients who survive), depression (29%), or posttraumatic stress disorder (44%). About 40% of patients are rehospitalized within 90 days of discharge, often for conditions that are potentially treatable in the outpatient setting, such as infection (11.9%) and exacerbation of heart failure (5.5%). Compared with patients hospitalized for other diagnoses, those who survive sepsis (11.9%) are at increased risk of recurrent infection than matched patients (8.0%) matched patients (P < .001), acute renal failure (3.3% vs 1.2%, P < .001), and new cardiovascular events (adjusted hazard ratio [HR] range, 1.1-1.4). Reasons for deterioration of health after sepsis are multifactorial and include accelerated progression of preexisting chronic conditions, residual organ damage, and impaired immune function. Characteristics associated with complications after hospital discharge for sepsis treatment are not fully understood but include both poorer presepsis health status, characteristics of the acute septic episode (eg, severity of infection, host response to infection), and quality of hospital treatment (eg, timeliness of initial sepsis care, avoidance of treatment-related harms). Although there is a paucity of clinical trial evidence to support specific postdischarge rehabilitation treatment, experts recommend referral to physical therapy to improve exercise capacity, strength, and independent completion of activities of daily living. This recommendation is supported by an observational study involving 30 000 sepsis survivors that found that referral to rehabilitation within 90 days was associated with lower risk of 10-year mortality compared with propensity-matched controls (adjusted HR, 0.94; 95% CI, 0.92-0.97, P < .001). Conclusions and Relevance: In the months after hospital discharge for sepsis, management should focus on (1) identifying new physical, mental, and cognitive problems and referring for appropriate treatment, (2) reviewing and adjusting long-term medications, and (3) evaluating for treatable conditions that commonly result in hospitalization, such as infection, heart failure, renal failure, and aspiration. For patients with poor or declining health prior to sepsis who experience further deterioration after sepsis, it may be appropriate to focus on palliation of symptoms.
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“Around 15% develop one to two significant functional limitations, cognitive impairments, or mental health conditions”
From On race, human variation, and who gets and dies of sepsis (2022) · cites this paper as Prescott & Angus, 2018
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Nearly 60% of all people released from hospitals after sepsis are readmitted within the year. Approximately 40% die within 2 years, 80% within 5 years”
From On race, human variation, and who gets and dies of sepsis (2022) · cites this paper as Prescott & Angus, 2018
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In the citing paper
“Additionally, living in neighborhoods with low SES is associated with an increased risk of sepsis (575), community-acquired bacteremia (575) and death from bacteremia (576) and worse outcomes (577).”
From Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. (2021) · cites this paper as [577]
Experimental — accuracy not yet measuredIn the citing paper
“Almost 40% of sepsis survivors are re-hospitalised within 3 months, often for preventable conditions [580], contributing to increased healthcare costs [581].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [580]
In the citing paper
“In addition, sepsis survivors are at increased risk for recurrent infection, AKI and new cardiovascular events compared to patients hospitalised for other diagnoses [580].”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [580]
In the citing paper
“There are a growing number of online resources and informational brochures regarding “post intensive care” / “post-sepsis syndrome”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [580]
In the citing paper
“Nonetheless, based on their strong rationale, and benefit in related populations [580] (e.g., older patients with cognitive impairment, patients following stroke or traumatic brain injury), we suggest referral to rehabilitation programmes in survivors of sepsis.”
From Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 (2021) · cites this paper as [580]
In the citing paper
“Clinical studies have shown that the incidence of moderate-to-severe cognitive impairment in patients who survive severe sepsis is as high as 70% (Prescott & Angus, 2018).”
From The modulatory effects of gut microbes and metabolites on blood-brain barrier integrity and brain function in sepsis-associated encephalopathy (2023) · cites this paper as Prescott & Angus, 2018
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“Notably, half of the survivors do not fully recover, and cerebral dysfunction, known as sepsis- associated encephalopathy (SAE), can persist even years after hospital discharge (Prescott & Angus, 2018; van der Slikke et al., 2020).”
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“The profound consequences of such cognitive impairment contribute to decreased independence for activities of daily living, worse quality of life, and inability to return to work (2).”
BackgroundPolarization of Microglia and Its Therapeutic Potential in Sepsis
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BackgroundInfluentialDivergent Sepsis Pathophysiology in Older Adults
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“One possible explanation can be that more patients in the explicit group had zero comorbidities and thus supposedly better long-term outcomes than those with comorbidities [22].”
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Pathophysiology and Treatment Strategies of Acute Myopathy and Muscle Wasting after Sepsis
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“Sepsis survivors who return home frequently face exacerbation of comorbidities and develop chronic physical disability due to discontinued hospital physical therapy (PT) or occupational therapy (OT) [1].”
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“In addition, each year, there are approximately 14 million sepsis survivors who have an increased risk of recurrent infections and hospital readmissions, and this comes with grave physical and financial consequences (Prescott & Angus, 2018).”
BackgroundNeurochemical effects of sepsis on the brain
Barichello, T., Giridharan, V. V., Catalão, C. H. R., Ritter, C., & Dal‐Pizzol, F. (2023) · Clinical Science · doi:10.1042/cs20220549 · Cited by 45
Psychocognitive sequelae of critical illness and correlation with 3 months follow up
Karnatovskaia, L. V., Schulte, P. J., Philbrick, K. L., Johnson, M. M., Anderson, B. K., Gajic, O., & Clark, M. M. (2019) · Journal of Critical Care · doi:10.1016/j.jcrc.2019.04.028 · Cited by 44
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“function, which warrants further exploration into novel strategies for improvements (3, 4).”
BackgroundČaval, T., Lin, Y., Varkila, M. R. J., Reiding, K. R., Bonten, M. J. M., Cremer, O. L., Franc, V., & Heck, A. J. R. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2020.608466 · Cited by 40
Mankowski, R. T., Anton, S. D., Ghita, G. L., Brumback, B., Darden, D. B., Bihorac, A., Leeuwenburgh, C., Moldawer, L. L., Efron, P. A., Brakenridge, S. C., et al. (2021) · The Journals of Gerontology Series A · doi:10.1093/gerona/glab080 · Cited by 41
“The etiology of these poor long-term outcomes after sepsis in older adults is unclear and undoubtedly multifactorial (9).”
BackgroundTang, Y., Wu, J., Sun, X., Tan, S., Li, W., Yin, S., Liu, L., Chen, Y., Liu, Y., Tan, Q., et al. (2024) · Cell Reports · doi:10.1016/j.celrep.2024.114237 · Cited by 39
Gračner, T., Agarwal, M., Murali, K. P., Stone, P. W., Larson, E., Furuya, E. Y., Harrison, J. M., & Dick, A. W. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.7528 · Cited by 41
Inclusion of social determinants of health improves sepsis readmission prediction models
Amrollahi, F., Shashikumar, S. P., Meier, A., Lucila Ohno-machado, A., Nemati, S., & Wardi, G. (2022) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocac060 · Cited by 38
Mohammed, M., Ibrahim, U. H., Aljoundi, A., Omolo, C. A., Devnarain, N., Gafar, M. A., Mocktar, C., & Govender, T. (2023) · International Journal of Pharmaceutics · doi:10.1016/j.ijpharm.2023.122967 · Cited by 41
Wu, L., Ai, M., Feng, Q., Deng, S., Liu, Z., Zhang, L., & Ai, Y. (2019) · Journal of Critical Care · doi:10.1016/j.jcrc.2019.04.018 · Cited by 40
Dupuis, C., Sabra, A., Patrier, J., Chaize, G., Saighi, A., Féger, C., Vainchtock, A., GAILLAT, J., & Timsit, J. (2021) · Critical Care · doi:10.1186/s13054-020-03442-z · Cited by 38
“Our observed mortality is similar to the overall 1-year post-ICU mortality reported by a Dutch study [14] but lower than that of a US study after ICU stay for sepsis [15] and a Finnish study in ICU patients with severe CAP [16].”
ResultImmunological Endotyping of Chronic Critical Illness After Severe Sepsis
Fenner, B. P., Darden, D. B., Kelly, L. S., Rincon, J. C., Brakenridge, S. C., Larson, S. D., Moore, F. A., Efron, P. A., & Moldawer, L. L. (2021) · Frontiers in Medicine · doi:10.3389/fmed.2020.616694 · Cited by 41
“Post-hospitalization, Prescott and Angus in their 2018 JAMA review of enhancing recovery from sepsis had only three recommendations: (1) identify new problems and treat appropriately, (2) review and adjust long-term medications, and (3) evaluate for treatable conditions that result in rehospitalization (10).”
BackgroundPei, Y., Xie, S., Li, J., & Jia, B. (2021) · Immunopharmacology and Immunotoxicology · doi:10.1080/08923973.2021.1955920 · Cited by 38
“The in-hospital mortality of sepsis has seen a decline in the past decades [27], though there are no curable pharmacological treatments specifically for sepsis [28].”
BackgroundSoni, S., Martens, M. D., Takahara, S., Silver, H. L., Maayah, Z. H., Ussher, J. R., Ferdaoussi, M., & Dyck, J. R. B. (2022) · Biochimica et Biophysica Acta (BBA) - Molecular Basis of Disease · doi:10.1016/j.bbadis.2022.166507 · Cited by 40
Dong, J., Chen, R., Song, X., Guo, Z., & Sun, W. (2023) · Heart & Lung · doi:10.1016/j.hrtlng.2023.03.002 · Cited by 43
Domizi, R., Adrario, E., Damiani, E., Scorcella, C., Carsetti, A., Giaccaglia, P., Casarotta, E., Gabbanelli, V., Pantanetti, S., Lamura, E., et al. (2019) · Annals of Intensive Care · doi:10.1186/s13613-019-0609-5 · Cited by 39
de Sousa, V. L., Araújo, S. M. B., Antônio, L. M. D. S., Silva-Queiroz, M., Colodeti, L. C., Soares, C., Barros‐Aragão, F. G. Q., Mota-Araujo, H. P., Alves, V. S., Coutinho‐Silva, R., et al. (2021) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2021.04.001 · Cited by 38
Liang, B., Su, J., Shao, H., Chen, H., & Xie, B. (2023) · Critical Care · doi:10.1186/s13054-023-04392-y · Cited by 41
“Despite significant advances in sepsis, no other treatment beyond basic therapy such as source of infection control, fluid resuscitation and vasoactive drugs has sufficient evidence to support to improve mortality [4], and sepsis survivors often suffer from residual organ injury [5].”
BackgroundInnovations in Geroscience to enhance mobility in older adults
Anton, S. D., Cruz‐Almeida, Y., Singh, A., Alpert, J. M., Bensadon, B. A., Cabrera, M., Clark, D. J., Ebner, N. C., Esser, K. A., Fillingim, R. B., et al. (2020) · Experimental Gerontology · doi:10.1016/j.exger.2020.111123 · Cited by 40
“tessential disease of the elderly” (Prescott and Angus, 2018).”
Tacconelli, E., Göpel, S., Gladstone, B. P., Eisenbeis, S., Hölzl, F., Buhl, M., Górska, A., Cattaneo, C., Mischnik, A., Rieg, S., et al. (2022) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(21)00587-9 · Cited by 36
Effect of Serum Ferritin on the Prognosis of Patients with Sepsis: Data from the MIMIC-IV Database
Fang, Y., Zhang, H., Guo, Z., Ren, C., Zhang, Y., Liu, Q., Wang, Z., & Zhang, X. (2022) · Emergency Medicine International · doi:10.1155/2022/2104755 · Cited by 36
“Terefore, sepsis is a signifcant public health problem as more than 19 million patients are diagnosed with sepsis each year and about 40% of septic patients are rehospitalized within their frst 90 days after discharge [2].”
BackgroundTie, X., Zhao, Y., Sun, T., Zhou, R., Li, J., Su, J., & Yin, W. (2024) · Frontiers in Nutrition · doi:10.3389/fnut.2024.1433544 · Cited by 35
Christiansen, C. F., Thomsen, R. W., Schmidt, M., Pedersen, L. H., & Sørensen, H. T. (2019) · Intensive Care Medicine · doi:10.1007/s00134-019-05648-4 · Cited by 36
Trajectory of Cognitive Decline After Sepsis
Wang, H. E., Kabeto, M., Gray, M., Wadley, V. G., Muntner, P., Judd, S. E., Safford, M. M., Kempker, J. A., & Levine, D. A. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000004897 · Cited by 36
“org 1091 and increased social support (43).”
Advances in phototherapy for infectious diseases
Lu, M., Li, S., Liu, Y., Xu, B., Liu, S., Zhang, J., Zhou, D., & Liu, H. (2024) · Nano Today · doi:10.1016/j.nantod.2024.102327 · Cited by 34
Sepsis is a preventable public health problem
Kempker, J. A., Wang, H. E., & Martin, G. S. (2018) · Critical Care · doi:10.1186/s13054-018-2048-3 · Cited by 37
“This trajectory includes sepsis recurrence, longterm mortality, and long-term morbidity across domains of psychological, cognitive, and physical function [13, 14].”
BackgroundCourtright, K. R., Jordan, L., Murtaugh, C. M., Barrón, Y., Deb, P., Moore, S. M., Bowles, K. H., & Mikkelsen, M. E. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.0038 · Cited by 34
“The median (IQR) hospice length of stay was 10 (3-33) days, with 5729 (45.”
BackgroundEpigenetic Biomarkers for Human Sepsis and Septic Shock: Insights from Immunosuppression
Beltrán-García, J., Osca-Verdegal, R., Mateo, C. R., Carbonell, N., Ferreres, J., Rodríguez, M. D. P., Mulet, S., García-López, E., Pallardó, F. V., & García‐Giménez, J. L. (2020) · Epigenomics · doi:10.2217/epi-2019-0329 · Cited by 36
Role of microRNAs As Biomarkers in Sepsis-Associated Encephalopathy
Osca-Verdegal, R., Beltrán-García, J., Pallardó, F. V., & García‐Giménez, J. L. (2021) · Molecular Neurobiology · doi:10.1007/s12035-021-02445-3 · Cited by 34
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“Sepsis is a life-threatening multiple organ dysfunction syndrome (MODS) caused by the host’s malfunctioning immune response to microbial invasion with unacceptably high mortality, posing a serious threat to human health (Prescott and Angus, 2018).”
BackgroundApplication Prospect of the SOFA Score and Related Modification Research Progress in Sepsis
Wang, X., Guo, Z., Chai, Y., Wang, Z., Liao, H., Wang, Z., & Wang, Z. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12103493 · Cited by 41
“With the standardized treatment of sepsis, about 14 million patients diagnosed with sepsis survive and leave hospital each year [58]; about half of these patients fully or nearly fully recover, and 1/3 of them die during this period.”
BackgroundDestabilisation of T cell-dependent humoral immunity in sepsis
Davies, K., & McLaren, J. E. (2024) · Clinical Science · doi:10.1042/cs20230517 · Cited by 34
“Although intensive care unit (ICU) mortality rates have improved in recent years, 40% of survivors are re-hospitalised within 90 days of discharge, and a striking one-third of discharged patients die within the following year [17].”
BackgroundThe Evolution of Post Intensive Care Syndrome
McPeake, J. M., & Mikkelsen, M. E. (2018) · Critical Care Medicine · doi:10.1097/ccm.0000000000003232 · Cited by 34
“between critical illness and PICS (7).”
Li, S., Zhao, D., Cui, J., Wang, L., Ma, X., & Li, Y. (2020) · Journal of International Medical Research · doi:10.1177/0300060519895659 · Cited by 33
“Worldwide, an estimated 19 million people each year develop sepsis, a life-threatening organ dysfunction caused by an aberrant immune response to an infection.(1,2) Acute respiratory distress syndrome (ARDS) is a common complication of sepsis.”
BackgroundLong-Term Survival Following Sepsis
Schmidt, K. F. R., Gensichen, J. S., Fleischmann-Struzek, C., Bahr, V., Pausch, C., Sakr, Y. L., Reinhart, K., Vollmar, H. C., Thiel, P., Scherag, A., et al. (2020) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2020.0775 · Cited by 33
“Owing to a multiplicity of physical and psychological sequelae, the disease burden of sepsis survivors is not restricted to the period of acute care in hospital (7).”
BackgroundReadmission Diagnoses After Pediatric Severe Sepsis Hospitalization*
Carlton, E. F., Kohne, J. G., Shankar‐Hari, M., & Prescott, H. C. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000003646 · Cited by 32
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“Cardiac dysfunction is prevalent in patients with sepsis (2,3), who have a poor prognosis (4,5).”
BackgroundYou, J., Fu, Z., & Zou, L. (2021) · Frontiers in Microbiology · doi:10.3389/fmicb.2021.761338 · Cited by 33
“Sepsis is caused by the accumulation of various pro-inflammatory factors in the process of inflammatory response and immune dysfunction (Prescott and Angus, 2018).”
BackgroundA Zinc‐ and Calcium‐Rich Lysosomal Nanoreactor Rescues Monocyte/Macrophage Dysfunction under Sepsis
Zhao, Q. P., Gong, Z., Wang, J., Fu, L., Zhang, J., Wang, C., Miron, R. J., Yuan, Q., & Zhang, Y. (2023) · Advanced Science · doi:10.1002/advs.202205097 · Cited by 32
Fleischmann-Struzek, C., Born, S., Kesselmeier, M., Ely, E. W., Töpfer, K., Romeike, H., Bauer, M. W., Bercker, S., Bodechtel, U., Fiedler, S., et al. (2024) · The Lancet Regional Health - Europe · doi:10.1016/j.lanepe.2024.101066 · Cited by 34
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What is new and different in the 2021 Surviving Sepsis Campaign guidelines
Prescott, H. C., & Ostermann, M. (2023) · Medizinische Klinik - Intensivmedizin und Notfallmedizin · doi:10.1007/s00063-023-01028-5 · Cited by 37
Self-citationS3-Leitlinie Sepsis – Prävention, Diagnose, Therapie und Nachsorge
Deutsche Sepsis Gesellschaft e., V., Brunkhorst, F. M., Weigand, M. A., Pletz, M. W., Gastmeier, P., Lemmen, S., Meier‐Hellmann, A., Ragaller, M., Weyland, A., Marx, G., et al. (2020) · Medizinische Klinik - Intensivmedizin und Notfallmedizin · doi:10.1007/s00063-020-00671-6 · Cited by 31
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“Furthermore, it is estimated that 17% of the patients experience severe and persistent physical, cognitive, and psychological disability and about 30% die during the following year post discharge [2].”
Background
Metadata
- Authors
- Prescott, H. C., & Angus, D. C.
- Affiliations
- University of Michigan (US)
- University of Pittsburgh (US)
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2018-01-02
- Volume
- 319
- Issue
- 1
- Pages
- 62
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC5839473
- OpenAlex
- W2782135811
- Semantic Scholar
- 98cad261fafa6b5df5332a165d01f11de1afd48e
- Cited by
- 1,059
- References
- 93
- Citations by year
- 2026: 143 · 2025: 149 · 2024: 161 · 2023: 142 · 2022: 124 · 2021: 135 · 2020: 103 · 2019: 67 · 2018: 32
- FWCI
- 65.73
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of General Medical Sciences (R01GM097471, K08GM115859)
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Sepsis Diagnosis and Treatment
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Nursing › Nutrition and Dietetics › Vitamin C and Antioxidants Research
- Keywords
- sepsis survivors, post-hospital care, post-discharge rehabilitation, physiotherapy referral, functional recovery, cognitive impairment, post-traumatic stress disorder, depression, anxiety, hospital readmission, recurrent infections, acute kidney injury, cardiovascular events, activities of daily living, sepsis severity, immune dysfunction, hospital quality of care, sepsis management guidelines
- MeSH terms
- Activities of Daily Living, Adult, Mental Disorders, Cognition Disorders, Hospitalization, Humans, Sepsis
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