Table 1.

Matched Cohort Studies Examining Risk for Physical Disability, Cognitive Impairment, and Common Medical Conditions in Patients Surviving a Hospitalization for Sepsis^a

Source	Study Population	Comparison	Findings
Physical Disability
Iwashyna et al,6 2010	516 HRS participants who survived hospitalization for sepsis, ≥65 y with linked Medicare claims	4517 HRS participants, ≥65 y, who survived a nonsepsis hospitalization	Patients with no functional limitations prior to sepsis developed a mean 1.57 new limitations (95% CI, 0.99–2.15) after sepsis vs 0.48 new limitations among comparison patients (P < .001 for difference) Patients with mild to moderate limitations before sepsis developed a mean 1.50 new limitations (95% CI, 0.87–2.12) after sepsis hospitalization; 59.3% (95% CI, 55.5%–63.2%) of patients who completed follow-up assessment (median, 1 y postsepsis) had worse cognitive or physical function than their own presepsis baseline assessment
Cognitive Impairment
Iwashyna et al,6 2010	516 HRS participants who survived hospitalization for sepsis, ≥65 y, with linked Medicare claims	4517 HRS participants, ≥65 y, who survived a nonsepsis hospitalization	Moderate to severe cognitive impairment increased 10.6% after sepsis, from 6.1% presepsis to 16.7% postsepsis In a multivariable model, sepsis was associated with an adjusted OR of 3.34 (95% CI, 1.53–7.25) for developing moderate to severe cognitive impairment (P < .001), while nonsepsis hospitalization was not associated with increased odds (adjusted OR, 1.15; 95% CI, 0.80–1.67)
Shah et al,7 2013	198 CHS participants who survived a hospitalization for sepsis, 320 pneumonia, or 1049 infection	2556 CHS participants not hospitalized with infection	Adjusted HRs for progression to dementia were 2.28 (95% CI, 1.38–3.77) postsepsis, 2.24 (95% CI, 1.62–3.11) after pneumonia, and 1.98 (95% CI, 1.61–2.43) after infection (P < .001 for each)
Common Medical Conditions
Yende et al,8 2014	4179 Medicare beneficiaries who survived an ICU hospitalization for sepsis	4179 Medicare beneficiaries hospitalized in ICU without sepsis; 4179 hospitalized with infection; 4179 hospitalized without infection, and 4179 nonhospitalized. All controls were matched on age, sex, prior cardiovascular disease, and propensity for sepsis	Cardiovascular events occurred 29.5% of patients in the year after sepsis (498.2 events/1000 person-y) Rate of cardiovascular events was higher after sepsis vs matched population controls (incidence RR, 1.9; P < .01) and matched hospitalized controls (incidence RR, 1.1; P = .002). Rates were indistinguishable from matched ICU controls (P = .28)
Zielske et al,36 2014	30 Adult survivors of ICU stay with sepsis	30 Adult survivors of ICU stay without sepsis	After 14 d in the ICU, aspiration was present on fiberoptic endoscopic evaluation of swallowing in 63% (19/30) of patients with sepsis vs 23% (7/30) of patients without sepsis (P = .002)
Prescott et al,37 2015	2617 HRS participants who survived a sepsis hospitalization, ≥65 y with linked Medicare claims	2617 Age, sex, and health status–matched HRS participants who survived a hospitalization for a nonsepsis acute medical condition	90-d Hospital readmission for a principal diagnosis of infection occurred in 11.9% (95% CI, 11.9%–13.1%) after vs in 8.0% (95% CI, 7.0%–9.1%) of controls (P < .001 P Readmission for sepsis occurred in 167 patients (6.4%) of 2617 vs 73 (2.8%; P < .001) Readmission for acute renal failure occurred in 87 (3.3%) vs 30 (1.2%; P < .001) Readmission for acute respiratory failure occurred in 65 (2.5%) vs 38 (1.5%; P = .007) Readmission for aspiration pneumonitis occurred in 47 (1.8%) vs 31 (1.2%; P = .06)
Ou et al,38 2016	All 93 862 adult patients hospitalized with sepsis in Taiwan during a 3-y period, of whom, 67 926 were matched to population controls and 42 855 were matched to nonsepsis hospitalizations	67 926 Population controls and 42 855 survivors of nonsepsis hospitalization, matched by propensity for sepsis hospitalization	During long-term follow-up (average 6.7 y), patients postsepsis had increased risk of cardiovascular events vs matched population controls (adjusted HR, 1.37; 95% CI, 1.34–1.41) and matched survivors on nonsepsis hospitalization (adjusted HR, 1.27; 95% CI, 1.22–1.32)
Shen, et al,39 2016	All 10 818 adult patients hospitalized with sepsis in Taiwan during a 3-y period, who had no prior sepsis and survived to 90 d without recurrent sepsis	10 818 Age- and sex-matched population controls with no prior history of sepsis	During 8-y follow-up, 35.0% of patients after sepsis vs 4.3% of matched controls had a recurrent hospitalization for sepsis Adjusted HR for subsequent sepsis among sepsis survivors, 8.89 (95% CI, 8.04–9.83)

Abbreviations: CHS, Cardiovascular Health Study, an observational cohort study; HR, hazard ratio; HRS, US Health and Retirement Study, an observational cohort study; ICU, intensive care unit; OR, odds ratio; RR, rate ratio.

^aOu et al³⁸ defined sepsis by principal diagnosis of sepsis (ICD-9-CM 038.x). All other studies identified sepsis by evidence of acute infection plus acute organ dysfunction.