title: Understanding Long-Term Outcomes Following Sepsis: Implications and Challenges.
abstract: Sepsis is life-threating organ dysfunction due to infection. Incidence of sepsis is increasing and the short-term mortality is improving, generating more sepsis survivors. These sepsis survivors suffer from additional morbidities such as higher risk of readmissions, cardiovascular disease, cognitive impairment and of death, for years following index sepsis episode. In the first year following index sepsis episode, approximately 60 % of sepsis survivors have at least one rehospitalisation episode, which is most often due to infection and one in six sepsis survivors die. Sepsis survivors also have a higher risk of cognitive impairment and cardiovascular disease contributing to the reduced life expectancy seen in this population, when assessed with life table comparisons. For optimal design of interventional trials to reduce these bad outcomes in sepsis survivors, in-depth understanding of major risk factors for these morbid events, their modifiability and a causal relationship to the pathobiology of sepsis is essential. This review highlights the recent advances, clinical and methodological challenges in our understanding of these morbid events in sepsis survivors.
authors.affiliation: Critical Care Medicine, Guy's and St Thomas' NHS Foundation Trust, 1st Floor, East Wing, St Thomas' Hospital, London, SE17EH, UK. manu.shankar-hari@kcl.ac.uk.|Division of Asthma, Allergy and Lung Biology, Kings College London, London, SE1 9RT, UK. manu.shankar-hari@kcl.ac.uk.
authors.forename: Manu
authors.initials: M
authors.lastname: Shankar-Hari
authors.affiliation: Interdepartmental Division of Critical Care Medicine, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, D5 03, Toronto, ON, M4N 3M5, Canada.
authors.forename: Gordon D
authors.initials: GD
authors.lastname: Rubenfeld
keywords: Causality; Epidemiology; Long-term outcomes; Morbidity; Mortality; Sepsis; Survivors