title: Determinants of functional status among survivors of severe sepsis and septic shock: One-year follow-up.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
authors.affiliation: Department of Clinical Pharmacist, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia.
authors.forename: Mustafa S
authors.initials: MS
authors.lastname: Al Khalaf
authors.affiliation: Research Coordinator, King Abdullah International Medical Research Centre (KAIMRC), Riyadh, Saudi Arabia.
authors.forename: Fatimah H
authors.initials: FH
authors.lastname: Al Ehnidi
authors.affiliation: Department of Intensive Care, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Al-Dorzi
authors.affiliation: King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
authors.forename: Hani M
authors.initials: HM
authors.lastname: Tamim
authors.affiliation: Department of Clinical Pharmacist, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia.
authors.forename: Noorizan
authors.initials: N
authors.lastname: Abd-Aziz
authors.affiliation: Department of Clinical Pharmacist, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia.
authors.forename: Balamurugan
authors.initials: B
authors.lastname: Tangiisuran
authors.affiliation: Department of Pharmacy Practice/Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800 Minden, Pulau Pinang, Malaysia.
authors.forename: Yahaya
authors.initials: Y
authors.lastname: Hassan
authors.affiliation: Department of Intensive Care, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: Yaseen M
authors.initials: YM
authors.lastname: Arabi
keywords: Disability; functional status; septic shock; severe sepsis
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