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
Experimental — accuracy not yet measuredThe check wasn’t confident either way, so it gives no verdict — never disputed.
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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Cites
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“Patients with sepsis can suffer from a broad spectrum of clinical sequelae in the areas of physical disability, cognitive impairment, mental health impairment, recurrent infection and sepsis, exacerbation of chronic conditions, all of which decrease overall functioning and quality of life (4, 19).”
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BackgroundTR4 worsen urosepsis by regulating GSDMD
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“Sepsis, defined by Sepsis 3.0 as infection-induced organ dysfunction, affects over 19 million patients annually, with 40% readmitted within 90 days (11–13).”
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Predicting early readmission or postdischarge mortality in survivors of postoperative sepsis
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Emerging elements of paediatric post-sepsis care programs: A scoping review
Middleton, N. J., Pienaar, C. A., Harvey, J. G., Rice, E., McCarthy, B., Gill, F. J., Blyth, C. C., Anastasas, K., Bale, T., Blyth, C., et al. (2025) · Australian Critical Care · doi:10.1016/j.aucc.2025.101316 · Cited by 1
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From Evidence to Bedside: The Role of Short-Acting β-Blockers in Sepsis Care
Arun, A. J., Darji, B., Baig, M., Frishman, W. H., & Aronow, W. S. (2025) · Cardiology in Review · doi:10.1097/crd.0000000000001040 · Cited by 1
Bu Zhong Yi Qi Tang targets key monocyte-associated genes to enhance sepsis therapy
Zhou, Y., Sun, W., Zhou, J., Yang, P., Wang, J., Xu, B., Hou, J., & Yang, K. (2025) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2025.120610 · Cited by 1
Experiencing Sepsis: A Meta-Ethnography
Johnston, M. W. S., Lorimer, A. J., Haines, K. J., & Litton, E. (2025) · Critical Care Medicine · doi:10.1097/ccm.0000000000006913 · Cited by 1
Bandyopadhyay, D., Mohapatra, L., Mishra, D. K., & Palei, N. N. (2025) · Biochemical and Biophysical Research Communications · doi:10.1016/j.bbrc.2025.153027 · Cited by 2
Leukocyte matrices in personalized immune status assessment of patients with sepsis
Савченко, А. А., Каспаров, Э. В., Borisov, S. A., Николаевна, А. Е., Черданцев, Д. В., Zdzitovetskiy, D. E., Borisov, R. N., Kochenov, D. A., Savchenko, E. V., & Борисов, А. Г. (2025) · Cytokines and inflammation · doi:10.17816/ci694031 · Cited by 1
Botulism Sequelae: A Systematic Review
Kosenko, M. G., Rogozhina, V. V., Erdniev, T. N., Shakaryan, A. K., Tumurov, D. A., Ligskaya, E., Gadetskaya, S., Eremeeva, A. В., Andreeva, M., Pyatnitskaya, M., et al. (2025) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofaf773 · Cited by 1
“This aligns with findings from post-sepsis syndrome, where up to 50% of patients report long-term fatigue, cognitive dysfunction, and impaired health-related quality of life [45].”
Bouillon, M., Malandain, D., Dargère, S., Cattoir, V., Hello, S. L., & Gravey, F. (2025) · Diagnostic Microbiology and Infectious Disease · doi:10.1016/j.diagmicrobio.2025.117224 · Cited by 1
Jagesar, A. R., Smalbil, L., Galea, E., Struja, T., Dam, T. A., Hilders, P., Otten, M., Biesheuvel, L. A., Girbes, A. R. J., Thoral, P. J., et al. (2025) · Journal of Intensive Medicine · doi:10.1016/j.jointm.2025.07.002 · Cited by 1
“[2] These major strains on hospital and rehabilitation resources make sepsis a large source of expenditure for many healthcare systems.”
Long-Term Outcomes After Sepsis
Garrity, K., Docherty, C., McPeake, J. M., & McCall, P. J. (2025) · Clinics in Chest Medicine · doi:10.1016/j.ccm.2025.11.008 · Cited by 1
Ge, Y., Li, M., Wang, B., Zhang, Y., Zhou, X., Zhang, Y., Li, T., Li, Y., Fang, S., & Liu, W. (2025) · International Immunopharmacology · doi:10.1016/j.intimp.2025.116098 · Cited by 1
Cetirizine and Dexamethasone in Sepsis: Insights into Maresin-1 Signaling and Cytokine Regulation
Aydin, Y., Börkü, M. K., Uğur, K., Eröksüz, Y., Emre, E., İncili, C. A., Şahin, İ., Acarturk, İ. Z., Aydin, S., & Lee, D.-Y. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm15010198 · Cited by 1
“Sepsis is a life-threatening pathological process whose global incidence continues to rise [28–30].”
Characterization of social frailty in survivors of sepsis: a multicenter qualitative investigation
McPeake, J. M., Hamilton, C., Boehm, L. M., Toth, K. M., & Hartley, P. (2026) · Annals of the American Thoracic Society · doi:10.1093/annalsats/aaoaf050 · Cited by 2
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“These alterations precipitate significantly elevated post-discharge risk, with 50% of survivors requiring readmission and 16% adult patients dying within one year [8].”
Kang, Z., Hou, C., Qi, S., Li, Z., Bai, X., & Dong, X. (2026) · Critical Care Medicine · doi:10.1097/ccm.0000000000007088 · Cited by 1
“epsis remains a formidable challenge in critical care medicine, characterized by a paradoxical immune dysregulation involving a devastating storm alongside profound immunosuppression (1, 2).”
Yang, S. E., Meng, J., Johnston, C. J., Gavade, S., Schwieterman, W., Hubert, H., Newstead, M. W., Singer, B. H., & Spencer-Segal, J. L. (2026) · Brain Behavior and Immunity · doi:10.1016/j.bbi.2026.106535 · Cited by 1
“The finding further suggests that LCN2 could be a therapeutic target to alleviate the highly prevalent mood dysfunction in infection survivors (Jackson et al., 2014; Prescott and Angus, 2018a, 2018b).”
FNDC4 modulates macrophage responses and suppresses NF-κB in sepsis-induced lung injury
Chen, J., Li, J., Huang, Y., Fan, Y., Li, W., Ye, J., Liu, G., Jiang, B., Pan, S., & Gao, C. (2026) · Molecular Immunology · doi:10.1016/j.molimm.2026.03.001 · Cited by 1
Yue, S., Du, X., Li, X., & Zhou, L. (2026) · Frontiers in Cellular and Infection Microbiology · doi:10.3389/fcimb.2026.1690126 · Cited by 1
“Sepsis is a crucial public health problem worldwide, which mainly occurs in intensive care unit (ICU) patients, with increased incidence and mortality (Evans, 2018; Prescott and Angus, 2018).”
Zhang, R. Y., Long, F., Wu, J., Xu, W., Ruoming, T., Li, L., Long, Y., Su, L., & Qu, H. (2026) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2026.104413 · Cited by 3
RetractedLi, Y.-Q., Liu, A.-H., Zhang, X., Lv, N., Chen, T.-Q., Hao, C.-P., & Wu, D.-M. (2026) · Science in progress · doi:10.1177/00368504261442885 · Cited by 1
Gut microbiome in sepsis: from dysbiotic biomarker to precision and palliative decision-making
Wang, L.-M., Chen, C., Danzheng, J., & Zhao, J. (2026) · Frontiers in Medicine · doi:10.3389/fmed.2026.1811304 · Cited by 1
“As illustrated in Figure 1, microbiome-derived signals may further contribute to identifying patients with limited physiological reserve and a reduced likelihood of recovery (16, 48).”
Ho, D., Won, H. Y., Kim, Y., & Lim, W. (2026) · Advances in experimental medicine and biology · doi:10.1007/978-981-95-6872-7_12 · Cited by 1
Piñeiro, P., Sanchez, F., Calvo, A., Tudela, M., Ramos, S., García-Ramos, S., Benito, P., Solchaga, I., Vela, R., Menéndez, C., et al. (2026) · Journal of Personalized Medicine · doi:10.3390/jpm16050251 · Cited by 1
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“However, long-term mortality and morbidity among sepsis survivors remain high, with many individuals experiencing frequent hospitalizations, persistent organ dysfunction, and poor quality of life (11, 12).”
Guo, B., Wang, C., Chen, L., Chen, T., Jiang, X., Li, Z., Zi, C., Wang, Y., Tu, Y., & Wang, Z. (2026) · International Immunopharmacology · doi:10.1016/j.intimp.2026.116893 · Cited by 1
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“Several predisposing factors described in the literature—including prolonged mechanical ventilation, deep sedation, delirium, ECMO support, and complications such as ARDS— have been associated with an increased risk of long-term deficits in ICU survivors [80–83].”
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Does the timing of antibiotic administration matter in sepsis?
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Home-Based Care for Survivors of Critical Illness
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On behalf of the Korean Sepsis Alliance (KSA) investigators, Lee, K. J., Park, J. Y., Jeon, K., Ko, R., Suh, G. Y., Lim, S. Y., Lee, Y. J., Oh, D. K., Park, M.-H., et al. (2023) · Journal of Thoracic Disease · doi:10.21037/jtd-23-405 · Cited by 1
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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