Work

Incidence and risk factors of post-intensive care syndrome (PICS) in sepsis survivors: a prospective, observational study

Year: 2025

Type: article

Abstract: BACKGROUND: Post-intensive care syndrome (PICS) encompasses new or worsening impairments in physical, cognitive, or mental health that manifest and persist after critical illness, yet the burden of PICS in this population remains under-characterized. We sought to quantify the incidence of PICS in sepsis survivors and to identify its independent predictors. METHODS: We conducted a prospective observational study of adult sepsis patients discharged from the medical ICU of Jinling Hospital, Nanjing University School of Medicine, between October 2024 and February 2025. Comprehensive baseline data-including demographics, clinical characteristics, and ICU interventions-were collected. Standardized telephone and in-person assessments were performed at 1, 3, and 6 months post-discharge to diagnose PICS across physical, cognitive, and mental health domains. Multivariate logistic regression was used to determine risk factors associated with incident PICS. RESULTS: Of 238 eligible patients, 150 met all inclusion criteria and completed follow-up assessment. The incidence of PICS was 72% at 1 month, 68% at 3 months, and 44% at 6 months. Multi-domain impairment (≥ 2 domains) was present in 38%, 34%, and 20% of survivors at the same timepoints, respectively; concurrent impairment in all three domains declined from 10.7% to 0.7%. After adjustment, higher APACHE II scores (OR = 1.57, 95% CI 1.27-1.94, P < 0.001) and elevated peak blood glucose (OR = 2.23, 95% CI 1.54-3.23, P < 0.001) independently predicted PICS, whereas higher education level (OR = 0.66, 95% CI 0.53-0.82, P < 0.001) conferred protection. CONCLUSIONS: PICS is common among sepsis survivors, with incidence declining but remaining substantial up to 6 months after ICU discharge. APACHE II scores and glycaemic control are robust, modifiable predictors, while educational attainment appears protective. TRIAL REGISTRATION: Registered in the Chinese Clinical Trial Registry ChiCTR2400094977 (Date: 31/12/2024).

Source: BMC Anesthesiology

DOI: 10.1186/s12871-025-03547-4

Authors: Yu Zhang, Xiao-yu Yin, Meng-qing Zhang, Jian-jun Yang, Mu-huo Ji, Jin-chun Shen