Factors Predicting Activities of Daily Living among Sepsis Survivors after Hospital Discharge
Article Sidebar
Main Article Content
Abstract
Purpose: To study the power of prediction of cognition, sepsis severity, length of stay and nutrition status on the activities of daily living (ADL) among sepsis survivors after hospital discharge.
Design: A cross-sectional study with predictive correlational design was employed.
Methods: A simple random sampling was performed to recruit 106 sepsis survivors post hospital discharge after 2 weeks including both males and females aged ≥18 years. Instruments used for data collection included demographic questionnaires, medical history records, the Barthel Index - Thai version, Nutrition Triage 2013, and the Thai Mental State Examination. Multiple regression was used for data analysis.
Main findings: Cognition, sepsis severity, length of stay and nutrition status could significantly predict ADL two weeks post-discharge; and cognition emerged as the strongest predictor (β = .42, p < .001). All study factors could together explain 76% of the variance in ADL outcomes among sepsis survivors (R2 = .76).
Conclusion and recommendations: Cognition, sepsis severity, length of hospital stay, and nutritional status were significantly predict ADL in sepsis survivors at two weeks post-discharge. These findings support the implementation of systematic two-week follow-up protocols for sepsis survivors following hospital discharge. The results provide foundational evidence for developing longitudinal intervention programs aimed at enhancing ADL recovery among sepsis survivors in future research endeavors.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright Notice: Nursing Science Journal of Thailand has exclusive rights to publish and distribute the manuscript and all contents therein. Without the journal’s permission, the dissemination of the manuscript in another journal or online, and the reproduction of the manuscript for non-educational purpose are prohibited.
Disclaimer: The opinion expressed and figures provided in this journal, NSJT, are the sole responsibility of the authors. The editorial board bears no responsibility in this regard.
References
Rudd KE, Johnson SC, Agesa KM, Shackelford KA, Tsoi D, Kievlan DR, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200-11. doi: 10.1016/s0140-6736(19)32989-7.
World Health Organization. Global report on the epidemiology and burden of sepsis: current evidence, identifying gaps and future directions. Geneva: World Health Organization; 2020. 55 p.
Yoshihara I, Kondo Y, Okamoto K, Tanaka H. Sepsis-associated muscle wasting: a comprehensive review from bench to bedside. Int J Mol Sci. 2023;24(5):5040. doi: 10.3390/ijms24055040.
Fleischmann-Struzek C, Rose N, Freytag A, Spoden M, Prescott HC, Schettler A, et al. Epidemiology and costs of post sepsis morbidity, nursing care dependency, and mortality in Germany, 2013 to 2017. JAMA Netw Open. 2021;4(11):e2134290. doi: 10.1001/jamanetworkopen.2021.34290.
Jarczak D, Kluge S, Nierhaus A. Sepsis-pathophysiology and therapeutic concepts. Front Med (Lausanne). 2021;8:628302. doi: 10.3389/fmed.2021.628302.
Darden DB, Kelly LS, Fenner BP, Moldawer LL, Mohr AM, Efron PA. Dysregulated immunity and immunotherapy after sepsis. J Clin Med. 2021;10(8):1742. doi: 10.3390/jcm10081742.
Fleischmann-Struzek C, Born S, Kesselmeier M, Ely EW, Töpfer K, Romeike H, et al. Functional dependence following intensive care unit-treated sepsis: three-year follow-up results from the prospective Mid-German Sepsis Cohort (MSC). Lancet Reg Health Eur. 2024;46:101066. doi: 10.1016/j.lanepe.2024.101066.
Cox MC, Booth M, Ghita G, Wang Z, Gardner A, Hawkins RB, et al. The impact of sarcopenia and acute muscle mass loss on long-term outcomes in critically ill patients with intra-abdominal sepsis. J Cachexia Sarcopenia Muscle. 2021;12(5):1203-13. doi: 10.1002/jcsm.12752.
Bowles KH, Murtaugh CM, Jordan L, Barrón Y, Mikkelsen ME, Whitehouse CR, et al. Sepsis survivors transitioned to home health care: characteristics and early readmission risk factors. J Am Med Dir Assoc. 2020;21(1):84-90.e2. doi: 10.1016/j.jamda.2019.11.001.
Inoue S, Nakanishi N, Sugiyama J, Moriyama N, Miyazaki Y, Sugimoto T, et al. Prevalence and long-term prognosis of post-intensive care syndrome after sepsis: a single-center prospective observational study. J Clin Med. 2022;11(18):5257. doi: 10.3390/jcm11185257.
Parker AM, Sinha P, Needham DM. Biological mechanisms of cognitive and physical impairments after critical care. Rethinking the Inflammatory model?. Am J Respir Crit Care Med. 2021;203(6):665-67. doi: 10.1164/rccm.202010-3896ED.
Nakano H, Hashimoto H, Mochizuki M, Naraba H, Takahashi Y, Sonoo T, et al. Hypoalbuminemia on admission as an independent risk factor for acute functional decline after infection. Nutrients. 2020;13(1):26. doi: 10.3390/nu13010026.
Nakamura K, Ogura K, Ohbe H, Goto T. Clinical criteria for persistent inflammation, immunosuppression, and catabolism syndrome: an exploratory analysis of optimal cut-off values for biomarkers. J Clin Med. 2022;11(19):5790. doi: 10.3390/jcm11195790.
Lo Buglio A, Bellanti F, Carmignano DFP, Serviddio G, Vendemiale G. Association between Controlling Nutritional Status (CONUT) score and body composition, inflammation and frailty in hospitalized elderly patients. Nutrients. 2024;16(5):576. doi: 10.3390/nu16050576.
Hosokawa T, Kinoshita K, Ihara S, Nakagawa K, Iguchi U, Hirabayashi M, et al. Relationship between brain volume reduction during the acute phase of sepsis and activities of daily living in elderly patients: A prospective cohort study. PloS One. 2023;18(5):e0284886. doi: 10.1371/journal.pone.0284886.
Jamroenwong N, Piyarak S, Chaiwon C. Assessment and nursing care of a patient with septic shock. The Southern College Network Journal of Nursing and Public Health. 2020;7(1):319-30. (in Thai).
Pattana K, Sarachan A, Faksuk E, Suwonnaroop N, Yuttatri P, Thosingha O. Factors related to the level of daily living activity among elderly people living in low-cost apartment. Journal of The Royal Thai Army Nurses. 2021;22(3):488-97. (in Thai).
Prammanasudh B, Trakulhoon V. Practical application of nutrition assessment in adult patients by NT 2013. Thai Journal of Parenteral and Enteral Nutrition. 2020;28(2):1-15. (in Thai).
Phensiri W, Udommongkol C, Sithinamsuwan P, Vanapruks C, Povichian K. Dementia among Thai military retirees. Royal Thai Army Medical Journal. 2013;59(1):23-30. (in Thai).
Cao Y, Su Y, Guo C, He L, Ding N. Albumin level is associated with short-term and long-term outcomes in sepsis patients admitted in the ICU: a large public database retrospective research. Clin Epidemiol. 2023;15:263-73. doi: 10.2147/clep.S396247.
