Surviving Severe Sepsis: Is That Enough?
Critical Care Medicine August 2016 V.44 N.8 P.1603–1604
Department of Clinical Ethics Consult Service, UI Health, University of Illinois at Chicago, Chicago, IL
Sepsis and severe forms of sepsis is a frequent diagnosis in the ICU setting. “Sepsis is one of the oldest and most elusive syndromes in medicine” (1). The definition of severe sepsis includes a systemic inflammatory response to infection complicated by acute organ dysfunction (1). “Over 1,665,000 cases of sepsis occur in the United States each year, with a mortality rate up to 50%” (2). In the ICU setting survival of severe sepsis is a primary goal, however, quality-of-life (QoL) issues for these patients after discharge is of great concern to the patient and to their family and physicians who will be providing the follow-up care that may be complex and ongoing (3). Long after hospitalization, survivors of severe sepsis experience an impaired QoL and an ongoing feeling that they may be imposing a burden of care to their family and loved ones. This is especially true for survivors who where physically independent prior to severe sepsis, but after discharge are left with dependence on others in daily activities. Although the goal of care in the ICU setting is appropriately to cure sepsis and minimize morbidity, it may be that many survivors are not getting the ongoing care required for their complex physical, psychological, and emotional needs after discharge. A recent study reported that after 6 months, up to 80% of severe sepsis/septic shock survivors stopped coming to their follow-up consultations (4). It is important to study QoL for survivors of sepsis in order to provide patient-centered care and to assess goals of care frequently so survivors and their families are offered holistic care and are not lost to follow-up…..
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