Cognitive Impairment as a Predictor of Long-Term Outcomes in Septic Patients: A Retrospective Observational Study

Background The importance of long-term outcomes after sepsis has been increasingly emphasized in recent years; however, little is known about the relationship between pre-sepsis patient characteristics and long-term outcomes. This study examined the impact of patient characteristics pre-admission, specifically physical, cognitive, and emotional disorders, on long-term clinical outcomes of sepsis. Methods This was a single-center, retrospective study. From August 2014 to July 2016, this study included adult patients admitted to our hospital with a diagnosis of sepsis who were followed up for one year. These 76 patients were classified as Survivors (n=31; 40.8%) or Deceased (n=45; 59.2%), based on their one-year outcomes. Results In this study, sepsis patients (n=45; 59.0%) died within one year. Univariate analysis demonstrated that several factors were associated with 1-year mortality, including male, arrhythmias, Sepsis-2 severity, activities of daily living (ADL) difficulties, and cognitive impairment. Multiple logistic regression models employing significant parameters from univariate analysis revealed that cognitive impairment (CI) is an independent risk factor for 1-year outcome (OR 5.427, 95% CI 1.385-21.260, P=0.0152). Patient history and needs assessment revealed that all patients with pre-admission cognitive impairment were discharged bedridden after sepsis treatment, and they exhibited a significantly lower survival rate (p=0.0332) compared to patients without cognitive impairment. Conclusion These results indicate that pre-septic cognitive impairment is a significant independent predictor of poor long-term clinical outcomes for sepsis patients.