Post-discharge functional outcomes in older patients with sepsis

Ge, Sanyu; Zha, Ling; Tanaka, Aiko; Narii, Nobuhiro; Shimomura, Yoshimitsu; Komatsu, Masayo; Komukai, Sho; Murata, Fumiko; Maeda, Megumi; Kiyohara, Kosuke; Kitamura, Tetsuhisa; Fukuda, Haruhisa

doi:https://doi.org/10.1186/s13054-024-05080-1

Post-discharge functional outcomes in older patients with sepsis

Ge, Sanyu; Zha, Ling; Tanaka, Aiko et al.

Critical Care, 2024, 28, 281

Number of Access:694（2025-08-14 04:12 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/98344

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Title	Post-discharge functional outcomes in older patients with sepsis
Creator	CreatorName Ge, Sanyu
	researchmap permalink lingzha lingzha Scopus Author ID 57193822882 57193822882 CreatorName Zha, Ling
	NRID 1000070894658 1000070894658 ORCID 0000-0002-8990-1336 0000-0002-8990-1336 researchmap permalink aikotanakaicu aikotanakaicu CreatorName Tanaka, Aiko
	CreatorName Narii, Nobuhiro
	CreatorName Shimomura, Yoshimitsu
	NRID 1000080726315 1000080726315 researchmap permalink k_masayo k_masayo Scopus Author ID 56257724000 56257724000 CreatorName Komatsu, Masayo
	NRID 1000070794543 1000070794543 ORCID 0000-0002-4329-2520 0000-0002-4329-2520 researchmap permalink sho.komukai sho.komukai Scopus Author ID 57200127087 57200127087 CreatorName Komukai, Sho
	CreatorName Murata, Fumiko
	NRID 1000080961573 1000080961573 CreatorName Maeda, Megumi
	NRID 1000080581834 1000080581834 CreatorName Kiyohara, Kosuke
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 CreatorName Kitamura, Tetsuhisa
	NRID 1000030572119 1000030572119 CreatorName Fukuda, Haruhisa
Subject	All-cause mortality
	Care needs
	Claims
	Older patients
	Sepsis
Description	Ge S., Zha L., Tanaka A., et al. Post-discharge functional outcomes in older patients with sepsis. Critical Care 28, 281 (2024); https://doi.org/10.1186/s13054-024-05080-1.
Abstract	Background: The post-discharge prognosis of patients with sepsis remains a crucial issue; however, few studies have investigated the relationship between pre-sepsis health status and subsequent prognosis in a large population. This study aimed to examine the effect of the pre-sepsis care needs level on changes in care needs and mortality in patients with sepsis 1 year post-discharge. Methods: This was a population-based retrospective cohort study including twelve municipalities in Japan that participated in the Longevity Improvement & Fair Evidence study between April 2014 and March 2022, with a total of 1,491,608 persons. The pre-hospitalization levels of care needs (baseline) were classified from low to high, as no care needs, support level and care needs level 1, care needs levels 2–3, and care needs levels 4–5 (fully dependent). The outcomes were changes in care needs level and mortality 1 year post-discharge, assessed by baseline care needs level using Cox proportional hazard models. Results: The care needs levels of 17,648 patients analyzed at baseline were as follows: no care needs, 7982 (45.2%); support level and care needs level 1, 3736 (21.2%); care needs levels 2–3, 3089 (17.5%); and care needs levels 4–5, 2841 (16.1%). At 1 year post-discharge, the distribution of care needs were as follows: no care needs, 4791 (27.1%); support level and care needs level 1, 2390 (13.5%); care needs levels 2–3, 2629 (14.9%); care needs levels 4–5, 3373 (19.1%); and death, 4465 (25.3%). Patients with higher levels of care needs exhibited an increased association of all-cause mortality 1 year post-discharge after adjusting for confounders [hazard ratios and 95% confidence intervals: support level and care needs level 1, 1.05 (0.96, 1.15); care needs levels 2–3, 1.46 (1.33, 1.60); and care needs levels 4–5, 1.92 (1.75, 2.10); P for trend < 0.001]. Conclusions: Elevated care needs and mortality were observed in patients with sepsis within 1 year post-discharge. Older patients with sepsis and higher baseline levels of care needs had a high association of all-cause mortality 1 year post-discharge.
Publisher	BioMed Central Ltd
Source Title	Critical Care
Volume (Issue)	28
Page	281
Date of Issued	2024-08-29
Language	English
Handle URL	https://hdl.handle.net/11094/98344
PISSN	13648535
eISSN	1466609X
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1186/s13054-024-05080-1
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	Critical Care. 2024, 28, p. 281
DC.title	Post-discharge functional outcomes in older patients with sepsis
DC.creator	Ge, Sanyu
	Zha, Ling
	Tanaka, Aiko
	Narii, Nobuhiro
	Shimomura, Yoshimitsu
	Komatsu, Masayo
	Komukai, Sho
	Murata, Fumiko
	Maeda, Megumi
	Kiyohara, Kosuke
	Kitamura, Tetsuhisa
	Fukuda, Haruhisa
DC.publisher	BioMed Central Ltd
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-08-29
DC.identifier	https://doi.org/10.1186/s13054-024-05080-1
DC.subject	All-cause mortality
	Care needs
	Claims
	Older patients
	Sepsis
DC.description	Ge S., Zha L., Tanaka A., et al. Post-discharge functional outcomes in older patients with sepsis. Critical Care 28, 281 (2024); https://doi.org/10.1186/s13054-024-05080-1.
DCTERMS.abstract	Background: The post-discharge prognosis of patients with sepsis remains a crucial issue; however, few studies have investigated the relationship between pre-sepsis health status and subsequent prognosis in a large population. This study aimed to examine the effect of the pre-sepsis care needs level on changes in care needs and mortality in patients with sepsis 1 year post-discharge. Methods: This was a population-based retrospective cohort study including twelve municipalities in Japan that participated in the Longevity Improvement & Fair Evidence study between April 2014 and March 2022, with a total of 1,491,608 persons. The pre-hospitalization levels of care needs (baseline) were classified from low to high, as no care needs, support level and care needs level 1, care needs levels 2–3, and care needs levels 4–5 (fully dependent). The outcomes were changes in care needs level and mortality 1 year post-discharge, assessed by baseline care needs level using Cox proportional hazard models. Results: The care needs levels of 17,648 patients analyzed at baseline were as follows: no care needs, 7982 (45.2%); support level and care needs level 1, 3736 (21.2%); care needs levels 2–3, 3089 (17.5%); and care needs levels 4–5, 2841 (16.1%). At 1 year post-discharge, the distribution of care needs were as follows: no care needs, 4791 (27.1%); support level and care needs level 1, 2390 (13.5%); care needs levels 2–3, 2629 (14.9%); care needs levels 4–5, 3373 (19.1%); and death, 4465 (25.3%). Patients with higher levels of care needs exhibited an increased association of all-cause mortality 1 year post-discharge after adjusting for confounders [hazard ratios and 95% confidence intervals: support level and care needs level 1, 1.05 (0.96, 1.15); care needs levels 2–3, 1.46 (1.33, 1.60); and care needs levels 4–5, 1.92 (1.75, 2.10); P for trend < 0.001]. Conclusions: Elevated care needs and mortality were observed in patients with sepsis within 1 year post-discharge. Older patients with sepsis and higher baseline levels of care needs had a high association of all-cause mortality 1 year post-discharge.
DC.rights	This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
DC.format	98344
citation_title	Post-discharge functional outcomes in older patients with sepsis
citation_author	Ge, Sanyu
	Zha, Ling
	Tanaka, Aiko
	Narii, Nobuhiro
	Shimomura, Yoshimitsu
	Komatsu, Masayo
	Komukai, Sho
	Murata, Fumiko
	Maeda, Megumi
	Kiyohara, Kosuke
	Kitamura, Tetsuhisa
	Fukuda, Haruhisa
citation_publisher	BioMed Central Ltd
citation_language	English
citation_date	2024-08-29
citation_journal_title	Critical Care
citation_volume	28
citation_firstpage	281
citation_doi	https://doi.org/10.1186/s13054-024-05080-1
citation_public_url	https://hdl.handle.net/11094/98344

Post-discharge functional outcomes in older patients with sepsis

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