Shankar-Hari Manu, Rubenfeld Gordon D
Critical Care Medicine, Guy's and St Thomas' NHS Foundation Trust, 1st Floor, East Wing, St Thomas' Hospital, London, SE17EH, UK.
Division of Asthma, Allergy and Lung Biology, Kings College London, London, SE1 9RT, UK.
Curr Infect Dis Rep. 2016 Nov;18(11):37. doi: 10.1007/s11908-016-0544-7.
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.
脓毒症是由感染引起的危及生命的器官功能障碍。脓毒症的发病率在上升，短期死亡率在改善，从而产生了更多的脓毒症幸存者。这些脓毒症幸存者在首次脓毒症发作后的数年里会遭受其他疾病的折磨，如再次入院风险增加、心血管疾病、认知障碍和死亡风险增加。在首次脓毒症发作后的第一年，约60%的脓毒症幸存者至少有一次再次住院，这最常见的原因是感染，六分之一的脓毒症幸存者死亡。与生命表比较时，脓毒症幸存者还具有更高的认知障碍和心血管疾病风险，这导致该人群预期寿命缩短。为了优化干预试验的设计以减少脓毒症幸存者的这些不良结局，深入了解这些病态事件的主要危险因素、它们的可改变性以及与脓毒症病理生物学的因果关系至关重要。本综述强调了我们在理解脓毒症幸存者这些病态事件方面的最新进展、临床和方法学挑战。
