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 cited source says what the claim attributes to it.
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]
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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
“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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Citations
Cites
The third international consensus definitions for sepsis and septic shock (Sepsis-3).
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., Bellomo, R., Bernard, G. R., Chiche, J.-D., Coopersmith, C. M., et al. (2016) · JAMA · doi:10.1001/jama.2016.0287 · Cited by 28,250 · cited 2×
“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 resu…”
Self-citationAngus, D. C., Linde-Zwirble, W. T., Lidicker, J., Clermont, G., Carcillo, J., & Pinsky, M. R. (2001) · Critical Care Medicine · doi:10.1097/00003246-200107000-00002 · Cited by 8,503 · cited 1×
“The most common underlying infection is pneumonia (40%), followed by abdominal, genitourinary, primary bacteremia, and skin or soft tissue infections.(15,16)”
Self-citationSurviving Sepsis Campaign: International guidelines for management of sepsis and septic shock: 2016.
Rhodes, A., Evans, L. E., Alhazzani, W., Levy, M. M., Antonelli, M., Ferrer, R., Kumar, A., Sevransky, J. E., Sprung, C. L., Nunnally, M. E., et al. (2017) · Intensive Care Medicine · doi:10.1007/s00134-017-4683-6 · Cited by 6,621 · cited 3×
“Early Hospital Treatment for Sepsis Early hospital care for sepsis focuses on prompt recognition, treatment with broad-spectrum antibiotics, elimination of infectious sources (eg, removing infected indwellingcatheters), and resuscitation with intravenous fluids and vasopressors for patients with low bloodpressureorele…”
InfluentialSelf-citationDiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000) · Archives of Internal Medicine · doi:10.1001/archinte.160.14.2101 · Cited by 4,177 · cited 1×
“However, it is important to recognize and treat mental health impairments because they are associated with a more complicated clinical course.(52,53)”
Severe Sepsis and Septic Shock
Angus, D. C., & van der Poll, T. (2013) · New England Journal of Medicine · doi:10.1056/nejmra1208623 · Cited by 4,119
Self-citationBarr, J., Fraser, G. L., Puntillo, K., Ely, E. W., Gélinas, C., Dasta, J. F., Davidson, J. E., Devlin, J. W., Kress, J. P., Joffe, A. M., et al. (2012) · Critical Care Medicine · doi:10.1097/ccm.0b013e3182783b72 · Cited by 3,896
Fleischmann, C., Scherag, A., Adhikari, N. K. J., Hartog, C. S., Tsaganos, T., Schlattmann, P., Angus, D. C., & Reinhart, K. (2016) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201504-0781oc · Cited by 3,548 · cited 2×
“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 resu…”
Self-citationSchweickert, W. D., Pohlman, M. C., Pohlman, A. S., Nigos, C., Pawlik, A. J., Esbrook, C. L., Spears, L., Miller, M., Franczyk, M., Deprizio, D., et al. (2009) · The Lancet · doi:10.1016/s0140-6736(09)60658-9 · Cited by 3,339
Wilson, I. B. (1995) · JAMA · doi:10.1001/jama.1995.03520250075037 · Cited by 3,027
Sepsis-induced immunosuppression: from cellular dysfunctions to immunotherapy
Hotchkiss, R. S., Monneret, G., & Payen, D. (2013) · Nature Reviews Immunology · doi:10.1038/nri3552 · Cited by 2,772 · cited 1×
“Many patients continue to have inflammatory changes, immune suppression, or both after sepsis.(19)”
Cited by
Sorted by citations
Wiersinga, W. J., Rhodes, A., Cheng, A. C., Peacock, S. J., & Prescott, H. C. (2020) · JAMA · doi:10.1001/jama.2020.12839 · Cited by 4,609
Self-citationSurviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021.
Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., et al. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000005337 · Cited by 2,935
Self-citationvan der Poll, T., Shankar‐Hari, M., & Wiersinga, W. J. (2021) · Immunity · doi:10.1016/j.immuni.2021.10.012 · Cited by 1,094
Sixty-day outcomes among patients hospitalized with COVID-19
Chopra, V., Flanders, S. A., O’Malley, M., Malani, A. N., & Prescott, H. C. (2021) · Annals of Internal Medicine · doi:10.7326/m20-5661 · Cited by 723
Self-citationThe Role of Inflammation in Depression and Fatigue
Lee, C.-H., & Giuliani, F. (2019) · Frontiers in Immunology · doi:10.3389/fimmu.2019.01696 · Cited by 662
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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