One-year outcomes in sepsis: a prospective multicenter cohort study in Japan
Abstract Background Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term ou...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-05-01
|
| Series: | Journal of Intensive Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40560-025-00792-0 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849325841405706240 |
|---|---|
| author | Keibun Liu Shinichi Watanabe Kensuke Nakamura Hidehiko Nakano Maiko Motoki Hiroshi Kamijo Matsuoka Ayaka Kenzo Ishii Yasunari Morita Takashi Hongo Nobutake Shimojo Yukiko Tanaka Manabu Hanazawa Tomohiro Hamagami Kenji Oike Daisuke Kasugai Yutaka Sakuda Yuhei Irie Masakazu Nitta Kazuki Akieda Daigo Shimakura Hajime Katsukawa Toru Kotani David McWilliams Peter Nydahl Stefan J. Schaller Takayuki Ogura the ILOSS Study Group |
| author_facet | Keibun Liu Shinichi Watanabe Kensuke Nakamura Hidehiko Nakano Maiko Motoki Hiroshi Kamijo Matsuoka Ayaka Kenzo Ishii Yasunari Morita Takashi Hongo Nobutake Shimojo Yukiko Tanaka Manabu Hanazawa Tomohiro Hamagami Kenji Oike Daisuke Kasugai Yutaka Sakuda Yuhei Irie Masakazu Nitta Kazuki Akieda Daigo Shimakura Hajime Katsukawa Toru Kotani David McWilliams Peter Nydahl Stefan J. Schaller Takayuki Ogura the ILOSS Study Group |
| author_sort | Keibun Liu |
| collection | DOAJ |
| description | Abstract Background Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions. Methods A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up. Results A total of 339 patients were included (median age 74 [67–82] years, 60% male, 77% septic shock, and a median SOFA of 9 [6–12]). Mortality was 23% at hospital discharge, increasing to 37% at 12 months. The rate of death or those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44%), high rates of hospital readmissions (40%), frequent emergency service usage (31%), and low utilization of rehabilitation and psychiatric services (15% and 7%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups. Conclusions This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433 |
| format | Article |
| id | doaj-art-e077a651c45b4ae2b20fd01022c50f3c |
| institution | Kabale University |
| issn | 2052-0492 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Intensive Care |
| spelling | doaj-art-e077a651c45b4ae2b20fd01022c50f3c2025-08-20T03:48:18ZengBMCJournal of Intensive Care2052-04922025-05-0113111210.1186/s40560-025-00792-0One-year outcomes in sepsis: a prospective multicenter cohort study in JapanKeibun Liu0Shinichi Watanabe1Kensuke Nakamura2Hidehiko Nakano3Maiko Motoki4Hiroshi Kamijo5Matsuoka Ayaka6Kenzo Ishii7Yasunari Morita8Takashi Hongo9Nobutake Shimojo10Yukiko Tanaka11Manabu Hanazawa12Tomohiro Hamagami13Kenji Oike14Daisuke Kasugai15Yutaka Sakuda16Yuhei Irie17Masakazu Nitta18Kazuki Akieda19Daigo Shimakura20Hajime Katsukawa21Toru Kotani22David McWilliams23Peter Nydahl24Stefan J. Schaller25Takayuki Ogura26the ILOSS Study GroupNon-Profit Organization ICU Collaboration Network (ICON)Department of Physical Therapy, Gifu University of Health ScienceDepartment of Critical Care Medicine, Yokohama City University HospitalDepartment of Emergency and Critical Care Medicine, Hitachi General HospitalDepartment of Emergency and Critical Care Medicine, Hitachi General HospitalDepartment of Emergency and Critical Care Medicine, Shinshu University School of MedicineDepartment of Emergency and Critical Care Medicine Faculty, Saga University HospitalDepartment of Anesthesiology, Intensive Care Unit, Fukuyama City HospitalDepartment of Emergency and Intensive Care Medicine, National Hospital Organization Nagoya Medical CenterDepartment of Emergency, Critical Care, and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesEmergency and Critical Care Medicine, Faculty of Medicine, University of TsukubaDepartment of Emergency, Tsukuba Medical Center HospitalDepartment of Rehabilitation, Japan Red Cross Narita HospitalTajima Emergency & Critical Care Medical Center, Toyooka Public HospitalDepartment of Rehabilitation, Tsuchiura Kyodo General HospitalDepartment of Emergency and Critical Care Medicine, Nagoya University Graduate School of MedicineDepartment of Intensive Care Medicine, Okinawa Kyodo HospitalDepartment of Emergency and Critical Care Medicine, Fukuoka University HospitalDepartment of Intensive Care Unit, Niigata University Medical and Dental HospitalDepartment of Emergency Medicine, SUBARU Health Insurance Society Ota Memorial HospitalGraduate School of Data Science, Shiga UniversityJapanese Society for Early MobilizationShowa Medical UniversityCentre for Care Excellence, Coventry UniversityNursing Research, University Hospital Schleswig-HolsteinDepartment of Anesthesia, Intensive Care Medicine and Pain Medicine, Clinical Division of General Anesthesia and Intensive Care Medicine, Medical University of ViennaDepartment of Emergency Medicine and Critical Care Medicine, Tochigi Prefectural Emergency and Critical Care Center, Saiseikai Utsunomiya HospitalAbstract Background Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions. Methods A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up. Results A total of 339 patients were included (median age 74 [67–82] years, 60% male, 77% septic shock, and a median SOFA of 9 [6–12]). Mortality was 23% at hospital discharge, increasing to 37% at 12 months. The rate of death or those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44%), high rates of hospital readmissions (40%), frequent emergency service usage (31%), and low utilization of rehabilitation and psychiatric services (15% and 7%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups. Conclusions This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433https://doi.org/10.1186/s40560-025-00792-0Intensive care unitMorbidityMortalityPost-intensive care syndromeQuality of lifeSepsis |
| spellingShingle | Keibun Liu Shinichi Watanabe Kensuke Nakamura Hidehiko Nakano Maiko Motoki Hiroshi Kamijo Matsuoka Ayaka Kenzo Ishii Yasunari Morita Takashi Hongo Nobutake Shimojo Yukiko Tanaka Manabu Hanazawa Tomohiro Hamagami Kenji Oike Daisuke Kasugai Yutaka Sakuda Yuhei Irie Masakazu Nitta Kazuki Akieda Daigo Shimakura Hajime Katsukawa Toru Kotani David McWilliams Peter Nydahl Stefan J. Schaller Takayuki Ogura the ILOSS Study Group One-year outcomes in sepsis: a prospective multicenter cohort study in Japan Journal of Intensive Care Intensive care unit Morbidity Mortality Post-intensive care syndrome Quality of life Sepsis |
| title | One-year outcomes in sepsis: a prospective multicenter cohort study in Japan |
| title_full | One-year outcomes in sepsis: a prospective multicenter cohort study in Japan |
| title_fullStr | One-year outcomes in sepsis: a prospective multicenter cohort study in Japan |
| title_full_unstemmed | One-year outcomes in sepsis: a prospective multicenter cohort study in Japan |
| title_short | One-year outcomes in sepsis: a prospective multicenter cohort study in Japan |
| title_sort | one year outcomes in sepsis a prospective multicenter cohort study in japan |
| topic | Intensive care unit Morbidity Mortality Post-intensive care syndrome Quality of life Sepsis |
| url | https://doi.org/10.1186/s40560-025-00792-0 |
| work_keys_str_mv | AT keibunliu oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT shinichiwatanabe oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT kensukenakamura oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT hidehikonakano oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT maikomotoki oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT hiroshikamijo oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT matsuokaayaka oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT kenzoishii oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT yasunarimorita oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT takashihongo oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT nobutakeshimojo oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT yukikotanaka oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT manabuhanazawa oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT tomohirohamagami oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT kenjioike oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT daisukekasugai oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT yutakasakuda oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT yuheiirie oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT masakazunitta oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT kazukiakieda oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT daigoshimakura oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT hajimekatsukawa oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT torukotani oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT davidmcwilliams oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT peternydahl oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT stefanjschaller oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT takayukiogura oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan AT theilossstudygroup oneyearoutcomesinsepsisaprospectivemulticentercohortstudyinjapan |