Cognitive impairment is a risk factor for long-term outcomes in septic patients: A retrospective observational study

The importance of long-term outcomes after sepsis has been increasingly emphasized in recent years; however, little is known about the relationship between pre-sepsis patient characteristics and long-term outcomes. This study examined the impact of patient characteristics pre-admission, specifically physical, cognitive, and emotional disorders, on long-term clinical outcomes of sepsis. From August 2014 to July 2016, this study included adult patients admitted to our hospital with a diagnosis of sepsis who were followed up for one year. These 76 patients were classified as Survivors (n=31) or Deceased (n=45), based on their one-year outcomes. In this single-center, retrospective study, 59% of sepsis patients died within one year. Multiple logistic regression models employing significant parameters from univariate analysis revealed that cognitive impairment (CI) is an independent risk factor for 1-year outcome [OR 0.184, 95% CI 0.047-0.722, P=0.0152]. Furthermore, through another univariate analysis and a log-rank test between the CI group and the Control group, created by reclassifying the same 76 patients, CI was significantly associated with a lower 1-year survival rate (25.0% vs 50.0%, P=0.03, log-rank P=0.0332). The composite outcome of either death or being bedridden at the point of discharge was also significantly higher in the CI group than the Control group (100.0% vs 75.0%, P=0.0028). These results indicate that pre-septic CI is a reliable, independent predictor of poor long-term clinical outcomes for sepsis patients. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The author(s) received no specific funding for this work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Not Applicable The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the ethics committee of Saga University Hospital (protocol identification number 2017-11-R-11). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Not Applicable I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Not Applicable I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Not Applicable Datasets generated and/or analyzed during the present study are not publicly available due to ethical restrictions associated with personal information, but anonymized data are available from the corresponding author on request.