"Sepsis is the leading cause of death among hospitalized patients. Patients discharged from the hospital aren't out of the woods yet. Approximately one out of every three sepsis survivors will die in the following year," said study lead author Dr. Sachin Yende. He is a professor of critical care medicine and clinical and translational science at the University of Pittsburgh's School of Medicine.
"Our new findings about chronic inflammation post-discharge suggest that addressing this condition may be important to improve patients' long-term outcomes," added Yende, vice president of critical care and deputy chief of staff at Veterans Affairs Pittsburgh Healthcare System.
Nearly all sepsis patients have increased inflammation in their bloodstream during the first few days of hospitalization, but how long the inflammation can persist and what effects it might have were unclear.
To find out, the researchers followed 483 people who survived hospitalization with sepsis at 12 U.S. hospitals between 2012 and 2017. They were assessed at three, six and 12 months after hospital discharge.
Up to a year after hospitalization, about one-fourth of the patients had elevated levels of inflammation and half had elevated levels of immunosuppression biomarkers, the findings showed.
These patients had higher rates of hospital readmission (particularly due to heart disease and stroke) and death than patients whose inflammation levels returned to normal after hospitalization.
According to senior study author Dr. Derek Angus, "The participants with increased inflammation had levels that were twice as high as levels in healthy individuals, and that elevated inflammation persisted long after hospital discharge." Angus is chair of the department of critical care medicine at the University of Pittsburgh.
"Sepsis increases risk of heart disease and stroke, and, for the first time, we've linked these adverse outcomes to persistent inflammation," he said in a university news release. "This opens the door to future studies into why high levels of inflammation persist for at least a year after hospital discharge, and the development of treatments aimed at modifying the inflammation with the hope that will improve health."
The study was published online Aug. 7 in JAMA Network Open.
Sepsis affects more than 30 million people worldwide every year, according to the World Health Organization.