Disease trajectory and mortality among sepsis patients: a prospective cohort study

Sepsis is a life-threatening disease and among the most common cause of death, which influence a series of following medical conditions. A comprehensive analysis of the cross-talks with temporary order of disease trajectory or trajectory led to cause of death following sepsis remains unclear. By using data from population-based UK Biobank, 8647 septic patients matching with 86386 controls without sepsis were included. Individuals were followed-up from 1 month after the index date until the end of 2019 with linkage of inpatient or death records to the registers. Then conditional Cox regression, binomial test together with conditional logistic regression were conducted to visualize the disease trajectories and trajectories leading to cause of death in sepsis survivors. During a median follow-up of 3.99 years, sepsis significantly increased the risk of 113 subsequent medical conditions. By visualizing disease-disease associations with time-dependent sequence, we identified four main affected disease clusters after sepsis, including circulatory, metabolic, respiratory and genitourinary system disease, further linking a series of downstream health outcomes. We also identified trajectories leading to mortality in three major categories of death in sepsis survivors, which were neoplastic, circulatory and respiratory system disease. In addition, disease trajectory after sepsis differed in gender and age groups were also explored in our study. These trajectory networks visualize a series of pathways linking sepsis to a broad range health conditions and provide potential intervention targeting these diseases for inhibiting adverse events in sepsis patients.