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Determinants of functional status among survivors of severe sepsis and septic shock: One-year follow-up
Mustafa S Al Khalaf1, Fatimah H Al Ehnidi2, Hasan M Al-Dorzi3, Hani M Tamim4, Noorizan Abd-Aziz1, Balamurugan Tangiisuran1, Yahaya Hassan5, Yaseen M Arabi3
1 Department of Clinical Pharmacist, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
2 Research Coordinator, King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia
3 Department of Intensive Care, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
4 King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
5 Department of Pharmacy Practice/Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia
Correspondence Address:
Yaseen M Arabi
Department of Intensive Care, King Abdulaziz Medical City, Associate Professor, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh
Saudi Arabia
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1737.150731
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RATIONALE: Sepsis is a leading cause of intensive care unit (ICU) admissions worldwide and a major cause of morbidity and mortality. Limited data exist regarding the outcomes and functional status among survivors of severe sepsis and septic shock.
OBJECTIVES: This study aimed to determine the functional status among survivors of severe sepsis and septic shock a year after hospital discharge.
METHODS: Adult patients admitted between April 2007 and March 2010 to the medical-surgical ICU of a tertiary hospital in Saudi Arabia, were included in this study. The ICU database was investigated for patients with a diagnosis of severe sepsis or septic shock. Survival status was determined based on hospital discharge. Patients who required re-admission, stayed in ICU for less than 24 hours, had incomplete data were all excluded. Survivors were interviewed through phone calls to determine their functional status one-year post-hospital discharge using Karnofsky performance status scale.
RESULTS: A total of 209 patients met the eligibility criteria. We found that 38 (18.1%) patients had severe disability before admission, whereas 109 (52.2%) patients were with severe disability or died one-year post-hospital discharge. Only one-third of the survivors had good functional status one-year post-discharge (no/mild disability). After adjustment of baseline variables, age [adjusted odds ratio (aOR) = 1.03, 95% confidence interval (CI) = 1.01-1.04] and pre-sepsis functional status of severe disability (aOR = 50.9, 95% CI = 6.82-379.3) were found to be independent predictors of functional status of severe disability one-year post-hospital discharge among survivors.
CONCLUSIONS: We found that only one-third of the survivors of severe sepsis and septic shock had good functional status one-year post-discharge (no/mild disability). Age and pre-sepsis severe disability were the factors that highly predicted the level of functional status one-year post-hospital discharge. |
