Sepsis alarmboek

30 31 Dr. Carolin Fleischmann-Struzek Jena University Hospital From analyzing nationwide health claims data in Germany, we learnt that three out of four sepsis survivors are affected by new mental, cognitive, or physical symptoms in the first year after sepsis. Thirty-one percent of survivors with no prior need for care have a new need for care, with potentially lifechanging impact for both patients and family. Notably, post-sepsis morbidity is found in all sepsis survivors but is more common after sepsis with organ failure and after ICU treatment than after sepsis without organ failure and without ICU treatment. A higher number of preexisting comorbidities increase the risk for adverse outcomes after sepsis. Long-term mortality in the first 12 months after discharge is also high – approximately one third of patients died in the first year post-discharge. Among previously employed survivors, about 25% do not resume work one year after hospital discharge. ‘A BETTER AFTERCARE IS NEEDED FOR ALL SEPSIS PATIENTS’ Despite this huge burden, only 6% of survivors are discharged directly from hospitalization to rehabilitation in Germany – a lower proportion than after most other acute, potentially disabling diseases such as stroke or myocardial infarction. A survival advantage, however, could be demonstrated for non-employed patients with rehabilitation compared with patients without rehabilitation in the 13-36 months after illness. Exploring perspectives of sepsis survivors and their caregivers, we found that they have a desire for more available and more specific follow-up therapies, structural support, and patient education. These data underline the huge need of structured aftercare and support for sepsis survivors and their families. Increased cross-sectoral, broadly available, and specific measures are needed to sustainably improve the care of more than one hundred thousand newly affected patients in Germany each year – a claim that is also raised by the WHO resolution “Improving the prevention, diagnosis and clinical management of sepsis”. Furthermore, it is important to intensify basic, clinical and health services research on post-sepsis syndrome, especially to identify and implement targeted interventions, which are currently lacking. Sepsis care does not stop at the end of the hospital – action is needed to provide adequate care for survivors. JAMA Netw Open. 2021;4(11):e2134290. doi:10.1001/ jamanetworkopen.2021.34290