Phenotypes of Functional Decline or Recovery in Sepsis ICU Survivors: Insights From a 1-Year Follow-Up Multicenter Cohort Analysis

作者：Keibun Liu, Takaya Nakashima, Tadahiro Goto, Kensuke Nakamura, Hidehiko Nakano, Maiko Motoki, Hiroshi Kamijo, Matsuoka Ayaka, Kenzo Ishii, Yasunari Morita, Takashi Hongo, Nobutake Shimojo, Yukiko Tanaka, Manabu Hanazawa, Tomohiro Hamagami, Kenji Oike, Daisuke Kasugai, Yutaka Sakuda, Yuhei Irie, Masakazu Nitta, Kazuki Akieda, Daigo Shimakura, Hajime Katsukawa, Toru Kotani, Peter Nydahl, Stefan J. Schaller, Takayuki Ogura, on behalf of the Investigating Long term Outcomes of ICU patients with Sepsis or Septic shock (ILOSS) Study Group · 发表于：Critical Care Medicine · 年份：2025 · DOI：10.1097/ccm.0000000000006621 · 被引用次数：15 · 研究领域：Intensive Care Unit Cognitive Disorders、Sepsis Diagnosis and Treatment、Frailty in Older Adults

OBJECTIVE: Sepsis often leads to heterogeneous symptoms of post-intensive care syndrome (PICS) composing physical, cognitive, and psychiatric disabilities, resulting in deteriorated quality of life (QoL), with limited interventions. This study aimed to identify phenotypes of sepsis-associated PICS by physical, cognitive, and psychiatric function and QoL at hospital discharge. DESIGN: A prospective observational study. SETTING: Twenty-one mixed ICUs. PATIENTS: All consecutive adult patients between November 2020 and April 2022, diagnosed with sepsis at ICU admissions and survived discharge, were enrolled. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Phenotyping with clusters determined by three approaches was performed with following variables at hospital discharge: Barthel Index (≤ 90 defined physical PICS), Short Memory Questionnaire (< 40 defined cognitive PICS), Hospital Anxiety and Depression Scale (≥ 8 defined psychiatric PICS), Impact of Event Scale-Revised (≥ 25 defined psychiatric PICS), EuroQoL 5-dimension 5-level, Clinical Frailty Scale hand-grip strength, and Medical Research Council. Each disability, employment, destination, and survival, were followed over the first year of hospital discharge. In total, 220 ICU patients were included (median age: 72.5 yr, 129 males (59%), 166 septic shocks (75%), and median Sequential Organ Failure Assessment Score: 8). Four phenotypes were identified: group 1 ( n = 62) with no PICS, group 2 ( n = 55) with mild PICS (physi...