One-year outcomes in sepsis: a prospective multicenter cohort study in Japan

ILOSS Study Group

doi:10.1186/s40560-025-00792-0

One-year outcomes in sepsis: a prospective multicenter cohort study in Japan

ILOSS Study Group

ICON
Gifu University of Health Science
Yokohama City University Hospital
Hitachi General Hospital
Shinshu University School of Medicine
Saga University Hospital
Fukuyama City Hospital
Nagoya Medical Center
Okayama University Graduate School of Medicine
University of Tsukuba
Tsukuba Medical Center Hospital
Japan Red Cross Narita Hospital
Toyooka Public Hospital
Tsuchiura Kyodo General Hospital
Nagoya University Graduate School of Medicine
Okinawa Kyodo Hospital
Fukuoka University Hospital
Niigata University Medical and Dental Hospital
Ota Memorial Hospital
Shiga University of Medical Science
Japanese Society for Early Mobilization
Showa Medical University
University Medical Center Schleswig Holstein
Medical University of Vienna
Tochigi Prefectural Emergency and Critical Care Center

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

17 Downloads (Pure)

Abstract

BACKGROUND: Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions.

METHODS: A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up.

RESULTS: A total of 339 patients were included (median age 74 [67-82] years, 60% male, 77% septic shock, and a median SOFA of 9 [6-12]). Mortality was 23% at hospital discharge, increasing to 37% at 12 months. The rate of death for those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44%), high rates of hospital readmissions (40%), frequent emergency service usage (31%), and low utilization of rehabilitation and psychiatric services (15% and 7%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups.

CONCLUSIONS: This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433.

Original language	English
Article number	23
Pages (from-to)	13-23
Number of pages	12
Journal	Journal of Intensive Care
Volume	13
Issue number	1
DOIs	https://doi.org/10.1186/s40560-025-00792-0
Publication status	Published - 1 May 2025

Bibliographical note

Open Access This article is licensed under a Creative Commons Attribution 4.0
International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you
give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes
were made

Funding

This project is supported by the Japanese Association for Acute Medicine.

Funders
Japanese Association for Acute Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

Intensive care unit
Morbidity
Mortality
Post-intensive care syndrome
Quality of life
Sepsis

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine

Access to Document

10.1186/s40560-025-00792-0Licence: CC BY

McWilliams2025VORFinal published version, 1.2 MBLicence: CC BY

Cite this

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title = "One-year outcomes in sepsis: a prospective multicenter cohort study in Japan",

abstract = "BACKGROUND: Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions.METHODS: A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up.RESULTS: A total of 339 patients were included (median age 74 [67-82] years, 60\% male, 77\% septic shock, and a median SOFA of 9 [6-12]). Mortality was 23\% at hospital discharge, increasing to 37\% at 12 months. The rate of death for those who met PICS Criteria at hospital discharge was 89\%, with a death or PICS incidence of 73\%, 64\%, and 65\% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44\%), high rates of hospital readmissions (40\%), frequent emergency service usage (31\%), and low utilization of rehabilitation and psychiatric services (15\% and 7\%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups.CONCLUSIONS: This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433.",

keywords = "Intensive care unit, Morbidity, Mortality, Post-intensive care syndrome, Quality of life, Sepsis",

author = "\{ILOSS Study Group\} and Keibun Liu and Shinichi Watanabe and Kensuke Nakamura and Hidehiko Nakano and Maiko Motoki and Hiroshi Kamijo and Matsuoka Ayaka and Kenzo Ishii and Yasunari Morita and Takashi Hongo and Nobutake Shimojo and Yukiko Tanaka and Manabu Hanazawa and Tomohiro Hamagami and Kenji Oike and Daisuke Kasugai and Yutaka Sakuda and Yuhei Irie and Masakazu Nitta and Kazuki Akieda and Daigo Shimakura and Hajime Katsukawa and Toru Kotani and David McWilliams and Peter Nydahl and Schaller, \{Stefan J\} and Takayuki Ogura",

note = " Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made",

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month = may,

day = "1",

doi = "10.1186/s40560-025-00792-0",

language = "English",

volume = "13",

pages = "13--23",

journal = "Journal of Intensive Care",

issn = "2052-0492",

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number = "1",

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TY - JOUR

T1 - One-year outcomes in sepsis

T2 - a prospective multicenter cohort study in Japan

AU - ILOSS Study Group

AU - Liu, Keibun

AU - Watanabe, Shinichi

AU - Nakamura, Kensuke

AU - Nakano, Hidehiko

AU - Motoki, Maiko

AU - Kamijo, Hiroshi

AU - Ayaka, Matsuoka

AU - Ishii, Kenzo

AU - Morita, Yasunari

AU - Hongo, Takashi

AU - Shimojo, Nobutake

AU - Tanaka, Yukiko

AU - Hanazawa, Manabu

AU - Hamagami, Tomohiro

AU - Oike, Kenji

AU - Kasugai, Daisuke

AU - Sakuda, Yutaka

AU - Irie, Yuhei

AU - Nitta, Masakazu

AU - Akieda, Kazuki

AU - Shimakura, Daigo

AU - Katsukawa, Hajime

AU - Kotani, Toru

AU - McWilliams, David

AU - Nydahl, Peter

AU - Schaller, Stefan J

AU - Ogura, Takayuki

N1 - Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made

PY - 2025/5/1

Y1 - 2025/5/1

N2 - BACKGROUND: Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions.METHODS: A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up.RESULTS: A total of 339 patients were included (median age 74 [67-82] years, 60% male, 77% septic shock, and a median SOFA of 9 [6-12]). Mortality was 23% at hospital discharge, increasing to 37% at 12 months. The rate of death for those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44%), high rates of hospital readmissions (40%), frequent emergency service usage (31%), and low utilization of rehabilitation and psychiatric services (15% and 7%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups.CONCLUSIONS: This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433.

AB - BACKGROUND: Sepsis is a leading cause of death in intensive care units (ICU). Sepsis survivors are often left with significant morbidity, termed post-intensive care syndrome (PICS), impacting post-sepsis life. The aim was to present detailed data on the prognostic and functional long-term outcomes of ICU patients with sepsis in Japan, which is currently lacking and therefore prevents development of targeted solutions.METHODS: A multicenter prospective study, involving 21 ICUs in 20 tertiary hospitals in Japan, included all consecutive adult ICU patients between November 2020 and April 2022, and diagnosed with sepsis at ICU admission (Sepsis 3). Follow-ups were performed at 3, 6, and 12 months after hospital discharge by telephone and mail. Primary outcome was death or incidence of PICS, defined by any of physical dysfunction (Barthel Index ≤ 90), cognitive dysfunction (Short Memory Questionnaire < 40), or mental disorder (any subscales for anxiety or depression of Hospital Anxiety and Depression Scale ≥ 8, or Impact of Event Scale-Revised ≥ 25). Secondary outcomes included Quality of Life (QOL), employment, and use of hospital, emergency, rehabilitation, and psychiatric services. A multivariable analysis investigated independent factors associated with each dysfunction at each follow-up.RESULTS: A total of 339 patients were included (median age 74 [67-82] years, 60% male, 77% septic shock, and a median SOFA of 9 [6-12]). Mortality was 23% at hospital discharge, increasing to 37% at 12 months. The rate of death for those who met PICS Criteria at hospital discharge was 89%, with a death or PICS incidence of 73%, 64%, and 65% at 3, 6, and 12 months, respectively. Limited improvements in QOL and return to work (44%), high rates of hospital readmissions (40%), frequent emergency service usage (31%), and low utilization of rehabilitation and psychiatric services (15% and 7%) were identified over the first year. The incidence of any PICS-related dysfunction was consistently an independent factor for the incidence of the same dysfunction at the following follow-ups.CONCLUSIONS: This multicenter study identified the distinct realities of post-sepsis life in Japanese ICU patients, highlighting the unique challenges in improving their functions and returning to daily life. Trial Registration University Hospital Medical Information Network UMIN000041433.

KW - Intensive care unit

KW - Morbidity

KW - Mortality

KW - Post-intensive care syndrome

KW - Quality of life

KW - Sepsis

UR - https://www.scopus.com/pages/publications/105004356638

U2 - 10.1186/s40560-025-00792-0

DO - 10.1186/s40560-025-00792-0

M3 - Article

C2 - 40307943

SN - 2052-0492

VL - 13

SP - 13

EP - 23

JO - Journal of Intensive Care

JF - Journal of Intensive Care

IS - 1

M1 - 23

ER -

One-year outcomes in sepsis: a prospective multicenter cohort study in Japan

Abstract

Bibliographical note

Funding

UN SDGs

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

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Correction to: One-year outcomes in sepsis: a prospective multicenter cohort study in Japan (Journal of Intensive Care, (2025), 13, 1, (23), 10.1186/s40560-025-00792-0)

Cite this