Livia Biason is a research medical doctor in the postgraduate program of respiratory sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil. Cassiano Teixeira is a professor in the Department of Internal Medicine and postgraduate program of rehabilitation science, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil, and a staff intensivist in the Department of Critical Care, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil. Jaqueline Sangiogo Haas is a staff nurse in the Department of Critical Care, Hospital de Clínicas de Porto Alegre. Cláudia da Rocha Cabral is a research nurse at the Universidade do Vale do Rio dos Sinos. Gilberto Friedman is a professor in the postgraduate program in respiratory sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, and a professor in the Department of Critical Care, Hospital de Clínicas de Porto Alegre.
Am J Crit Care. 2019 Nov;28(6):424-432. doi: 10.4037/ajcc2019638.
Morbidity and mortality after discharge from an intensive care unit appear to be higher in patients with sepsis than in patients without sepsis.
To evaluate morbidity and mortality in patients with and without sepsis within 2 years after intensive care unit discharge.
A prospective cohort study was conducted in 2 intensive care units. Patients who stayed in the intensive care unit longer than 24 hours were followed up for 2 years after discharge. Morbidity was assessed by using the Karnofsky scale, the Lawton instrumental activities of daily living scale, presence of pain, and readmissions.
During the study, 74.7% of patients (859 of 1150; 242 with sepsis, 617 without sepsis) were discharged from the intensive care unit. Compared with patients without sepsis, patients with sepsis had higher mortality during follow-up (57.4% vs 34.2%; < .001) and were 1.34 times as likely to die (per Cox regression). More patients with sepsis had pain (48.5% vs 35.2%, = .003) and read-missions (65.5% vs 55.0%, = .02). Patients with sepsis had a greater degree of functional loss, adjusted for confounding factors (mean [SD] change in Lawton scale score from intensive care unit admission to 2 years after intensive care unit discharge, 4.0 [8.0] vs 3.4 [8.2]; = .31).
Compared with patients without sepsis, those with sepsis have higher mortality in the intensive care unit and have more pain, hospital readmissions, and functional decline within 2 years after discharge.
与非脓毒症患者相比，重症监护病房（ICU）出院后的脓毒症患者的发病率和死亡率似乎更高。
评估 ICU 出院后 2 年内脓毒症和非脓毒症患者的发病率和死亡率。
在 2 个 ICU 中进行了前瞻性队列研究。在 ICU 停留超过 24 小时的患者在出院后随访 2 年。通过 Karnofsky 量表、Lawton 工具性日常生活活动量表、疼痛存在情况和再入院情况评估发病率。
在研究期间，74.7%（1150 例中的 859 例；242 例脓毒症，617 例非脓毒症）的患者从 ICU 出院。与非脓毒症患者相比，脓毒症患者在随访期间的死亡率更高（57.4% vs 34.2%；<.001），死亡风险增加 1.34 倍（根据 Cox 回归）。更多的脓毒症患者有疼痛（48.5% vs 35.2%， =.003）和再入院（65.5% vs 55.0%， =.02）。调整混杂因素后，脓毒症患者的功能丧失程度更大（从 ICU 入院到 ICU 出院后 2 年的 Lawton 量表评分平均（SD）变化，4.0（8.0）vs 3.4（8.2）； =.31）。
与非脓毒症患者相比，脓毒症患者在 ICU 中的死亡率更高，并且在出院后 2 年内疼痛、医院再入院和功能下降的情况更多。
