Post-discharge functional outcomes in older patients with sepsis

Area of Science:

• Gerontology
• Public Health
• Epidemiology

Background:

• Post-discharge prognosis for sepsis patients is critical.
• Limited research exists on pre-sepsis health status and sepsis prognosis in large populations.
• Understanding pre-sepsis care needs is vital for improving patient outcomes.

Purpose of the Study:

• To investigate the impact of pre-sepsis care needs level on changes in care needs.
• To examine the association between pre-sepsis care needs and mortality one year post-discharge in sepsis patients.
• To analyze the relationship between baseline care needs and one-year post-discharge outcomes.

Main Methods:

• Population-based retrospective cohort study in Japan (April 2014-March 2022).
• Included 1,491,608 individuals; analyzed 17,648 sepsis patients.
• Classified pre-hospitalization care needs (none, support, levels 1-5); assessed outcomes using Cox proportional hazard models.

Main Results:

• Higher baseline care needs significantly correlated with increased all-cause mortality one year post-discharge.
• Hazard ratios for mortality: support/level 1 (1.05), levels 2-3 (1.46), levels 4-5 (1.92).
• P-trend < 0.001 indicated a significant association between escalating care needs and mortality risk.

Conclusions:

• Sepsis patients experienced elevated care needs and mortality within one year post-discharge.
• Higher baseline care needs in older sepsis patients strongly predicted one-year all-cause mortality.
• Pre-sepsis care needs level is a significant predictor of sepsis patient prognosis.