Sepsis survivors are at an increased risk of death in the years following their illness, new research shows, prompting fresh calls for improved follow-up care.
Of those discharged from hospital in England after a critical care admission, three in 20 people (15%) died within 12 months, according to the study published in journal JAMA Network Open.
Led by Dr Manu Shankar-Hari, from Guy’s and St Thomas’ hospital in London, the research analysed data on 94,748 patients from 192 critical care units in England. All had survived to the point of hospital discharge following a critical care unit admission for sepsis between April 2009 and March 2014.
Of these, more than two in five (44%) had died by the end of March 2015.
Sepsis is a serious complication of an infection, which occurs when the body’s immune system overreacts and begins attacking organs and tissues. It can lead to multiple organ failure and death if it is not spotted in time.
There are around 250,000 cases of sepsis every year in the UK, according to the UK Sepsis Trust.
The study found being older, male and having multiple health problems increased the risk of death among sepsis survivors. The severity of the condition and length of hospital stay were also found to be possible risk factors.
Dr Shankar-Hari, a critical care physician, said: “This the first report of long-term risk of death in sepsis survivors using national data from England.
“We now know the magnitude of this long-term risk of death in sepsis survivors. Being able to identify patients at the highest risk is key for us as clinicians, as it helps to plan ongoing care.”
The focus now is to determine what the best interventions are to prevent these deaths, he said, as well as how to identify sepsis survivors who are at greatest risk of death.
“More importantly, this new research informs the health policy debate around how to plan follow-up care of sepsis survivors and critical illness survivors in general,” Shankar-Hari added.
Dr Ron Daniels, chief executive of the UK Sepsis Trust, said: “It’s important that we don’t allow these new findings to cause undue alarm for those recovering from sepsis.”
He pointed out that the research focuses specifically on patients admitted to intensive care units, who are already at a higher risk of death or long-term complications following sepsis.
“Whilst many survivors experience physical, physiological and emotional after-effects, the majority of people who survive sepsis will make a full recovery,” he said. “However, this kind of research is important as it highlights the need for better resources to inform survivors about the potential risks following sepsis, and better follow-up services for those people.”
Rose Gallagher, from the Royal College of Nursing, added that patients who survive sepsis are also left with long-term physical and psychological problems such as post-traumatic stress disorder (PTSD), chronic pain, fatigue, decreased cognitive function, anxiety, depression and insomnia.
“Life can be challenging not only for patients but also for their families,” she said. “The services to support these patients varies across the country and there is a need for properly-resourced follow up services to support their emotional, psychological and physical rehabilitation needs.”