Trajectories of sepsis survivors in Australia: A scoping review

Sepsis poses a substantial global health threat, accounting for approximately 20% of all deaths worldwide. In Australia, available reports indicate a rising incidence, with over 84,000 hospital admissions each year. Although in-hospital survival has improved, many survivors continue to experience long-term physical, psychological, cognitive, and health-related quality-of-life (HRQoL) challenges, collectively known as post-sepsis syndrome (PSS). However, research examining these long-term outcome trajectories remains fragmented and has not been comprehensively synthesised. This scoping review aims to map current evidence, clarify key concepts, and identify gaps in knowledge regarding PSS and related post-sepsis outcomes within the Australian context.

A scoping review was carried out in accordance with the updated methodological framework provided by the Joanna Briggs Institute (JBI). A comprehensive search across multiple databases was conducted, including both peer-reviewed and grey literature. Two reviewers independently screened and extracted data. Narrative thematic analysis was employed to identify key themes and knowledge gaps. Reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) checklist, and the review protocol was published on the Open Science Framework (OSF): https://doi.org/10.17605/osf.io/xhzfq.

Eighteen studies, primarily observational cohort designs, investigated outcomes among a total of 542,599 sepsis survivors. Less than half (39%) of the studies provide nationwide data. Six key themes emerged: long-term mortality risk, hospital readmissions, reduced HRQoL, long-term physical impairments, cognitive dysfunction, and mental health challenges. The most frequently reported outcomes were elevated post-hospital mortality and reduced HRQoL. Notably, 1-year mortality rates ranged from 12.5% to 36.9%. HRQoL was consistently impaired across all domains when compared to the general population. Despite ongoing needs in survivors, post-discharge rehabilitation and support services were reported to be inadequate.

This scoping review shows that sepsis survivors in Australia experience multidimensional long-term complications and increased mortality risk. Stakeholders need to provide greater emphasis on the development of tailored post-sepsis care models and follow-up strategies to improve life after experiencing sepsis. Moreover, methodological limitations in the existing literature-including inconsistent case definitions, limited outcome measurement, short follow-up, and insufficient exploration of factors-highlight the need for robust, longitudinal research to strengthen evidence bases.