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Association Between Sepsis and Microvascular Brain Injury
William J Ehlenbach1, Joshua A Sonnen2, Thomas J Montine3
1Department of Medicine, University of Wisconsin, Madison, WI.
Critical Care Medicine
|August 8, 2019
Summary
Sepsis hospitalization is linked to an increased risk of cerebral microinfarcts, particularly in the brain cortex. This study suggests a connection between sepsis and vascular brain injury, potentially explaining long-term cognitive issues in survivors.
Area of Science:
- Neurology
- Pathology
- Gerontology
Background:
- Sepsis survivors often experience long-term cognitive impairment.
- The underlying mechanisms linking sepsis to cognitive decline are not fully understood.
- Cerebral microinfarcts are small lesions associated with vascular brain injury and cognitive dysfunction.
Purpose of the Study:
- To investigate the association between sepsis hospitalization and the presence of cerebral microinfarcts on autopsy.
- To determine if sepsis contributes to vascular brain injury.
Main Methods:
- Retrospective cohort study of 529 older adults (≥65 years) from the Adult Changes in Thought study.
- Participants underwent brain autopsy; sepsis hospitalization was identified via administrative data.
- Cerebral microinfarcts, Braak stage, CERAD score, and Lewy bodies were assessed.
Main Results:
- 30% of sepsis survivors had >2 microinfarcts versus 19% of controls (p=0.02).
- Sepsis was associated with a 1.61-fold increased risk of microinfarcts (p=0.04).
- The risk of cortical microinfarcts was more than doubled in sepsis survivors (RR 2.12, p=0.02).
Conclusions:
- Sepsis hospitalization is significantly associated with moderate to severe vascular brain injury, evidenced by microinfarcts.
- This association is more pronounced for microinfarcts in the cerebral cortex.
- Further research is needed to elucidate the mechanisms connecting sepsis and microinfarct formation.
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