Cognitive impairment and functional impairment after illness are a significant problem for caregivers and public health in general, due to the significant economic costs of caring for these patients. Although severe sepsis is quite common in clinical practice and, in addition, there is a tendency for increased morbidity, the severity and extent of cognitive and functional impairment in patients who have experienced severe sepsis remain poorly understood.

The purpose of a study by scientists at the University of Michigan Faculty of Medicine (United States) was to identify cognitive and functional impairment in patients with severe sepsis.

The prospective cohort included 1,194 patients with 1,520 hospitalizations for severe sepsis from 1998 to 2006. In total, 9,223 respondents participated in the study, which carried out an initial assessment of cognitive functions and functional status; 516 patients who had severe sepsis and 4,517 patients hospitalized for other illnesses who had at least one follow-up survey were included in the analysis.

The average age of patients at the time of hospitalization was 76.9 years. The prevalence of moderate and severe cognitive impairment increased by 10.6% in patients after severe sepsis (odds ratio 3.34, 95% confidence interval 1.53-7.25). In addition, there was a high frequency of newly appeared functional limitations after sepsis (in patients without pre-disease limitations after sepsis, on average 1.57 newly appeared limitations were observed per patient (95% CI 0 , 99-2.15), and patients with mild and moderate severity of the pre-disease limb after sepsis experienced an average of 1.5 new limitations (95% CI 0.87–2.12). however, patients hospitalized for another reason did not change in cognitive function (relative odds were 1.15, 95% CI 0.8 to 1.67, p = 0.01 compared to patients with sepsis), and the incidence of newly emerging limitations was significantly lower (on average, 0.48 in patients with no pre-disease restrictions (95% CI 0.39-0.57), p less than 0.001 compared to patients with sepsis and, on average 0.43 (95% CI 0.23-0.63) in patients with mild and moderate severity of pre-disease limitations, p = 0.001 compared to patients with sepsis). The deterioration of the cognitive sphere and functional activity persisted in patients after sepsis for at least 8 years.

Thus, the results of this study indicate that severe sepsis in patients in the older age group is an independent risk factor for persistent and persistent cognitive impairment and functional disorders.