The risk for mental decline in an older person is almost three times as great after hospitalization for severe sepsis — a condition triggered by a strong immune reaction to an infection — than in patients of similar age hospitalized for other conditions, according to a study by the University of Michigan.
“This study should help change the way we think about severe sepsis,” said Theodore J. Iwashyna M.D., Ph.D.
“We usually think of severe sepsis as a medical emergency and focus our efforts on making sure the patient survives. This study shows that survivors often have severe problems for years afterwards.”
During sepsis, extensive inflammation is triggered when the body releases chemicals into the blood in order to fight a serious infection. Heart weakness, low blood pressure, and organ failure may follow.
Although anyone can get sepsis, infants, children, elderly people and individuals with weak immune systems are most at risk. People with sepsis are often admitted into intensive care units to treat the infection and support vital organs and blood pressure.
Severe sepsis was also linked to a stronger risk for developing at least one new limitation during daily activities after hospitalization.
“Sepsis is common in older people and has a high mortality rate,” said NIA Director Richard J. Hodes, M.D.
“This study shows that surviving sepsis may bring substantial and underrecognized problems with major implications for patients, families and the health care system.”
For the study, researchers used data from the Health and Retirement Study (HRS)—a long term study that gathers information on a health sample of Americans aged 50 and above—and observed the mental and physical functions of older people before and after they were hospitalized for severe sepsis.
The researchers analyzed data from 516 people—with an average age of 77—who survived 623 hospitalizations for severe sepsis between 1998 and 2005. They also researched the individuals’ data on cognitive function, taken by standard tests.
About 60 percent of patients with severe sepsis had declining cognitive or physical function in the first survey just after hospitalization. The risk of moderate or severe mental impairment in sepsis patients was 3.33 times higher than their risk before being hospitalized.
Severe sepsis was also found to be linked to the development of 1.57 new functional limitations in individuals who had no limitations before sepsis.
On the other hand, patients without sepsis and no functional limitations before hospitalization developed about 0.48 new functional limitations.
“This is one of more than a thousand research papers that have used Health and Retirement Study data,” said Richard Suzman, Ph.D., director of the NIA’s Division of Behavioral and Social Research, which supports the HRS.
“The uniquely rich HRS dataset enabled the analysis of both cognitive and physical function in relation to hospitalization for a very specific medical condition. I look forward to the investigators refining their findings in the future.”
The research was mainly supported by the National Institute on Aging (NIA) and can be found in the Journal of the American Medical Association.
Source: National Institutes of Health