Understanding Post-Sepsis Syndrome: How Can Clinicians Help?

Elisabeth C van der Slikke,1 Lise FE Beumeler,2,3 Madlene Holmqvist,4 Adam Linder,4 Robert T Mankowski,5 Hjalmar R Bouma1,6 1Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, the Netherlands; 2Department of Intensive Care, Medical Centre Leeuwarden, Leeuwarden, 8934AD, the Netherlands; 3Department of Sustainable Health, Campus Fryslân, University of Groningen, Groningen, 8911 CE, the Netherlands; 4Department of Infection Medicine, Skåne University Hospital Lund, Lund, 221 84, Sweden; 5Department of Physiology and Aging, University of Florida, Gainesville, FL, 32610, USA; 6Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, 9713GZ, the NetherlandsCorrespondence: Hjalmar R Bouma, Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, P.O. Box 30.001, EB70, Groningen, 9700 RB, the Netherlands, Tel +31 (0) 50 361 7870, Email [email protected]: Sepsis is a global health challenge, with over 49 million cases annually. Recent medical advancements have increased in-hospital survival rates to approximately 80%, but the escalating incidence of sepsis, owing to an ageing population, rise in chronic diseases, and antibiotic resistance, have also increased the number of sepsis survivors. Subsequently, there is a growing prevalence of “post-sepsis syndrome” (PSS). This syndrome includes long-term physical, medical, cognitive, and psychological issues after recovering from sepsis. PSS puts survivors at risk for hospital readmission and is associated with a reduction in health- and life span, both at short and long term, after hospital discharge. Comprehensive understanding of PSS symptoms and causative factors is vital for developing optimal care for sepsis survivors, a task of prime importance for clinicians. This review aims to elucidate our current knowledge of PSS and its relevance in enhancing post-sepsis care provided by clinicians.Keywords: post-sepsis syndrome, sepsis, long-term outcom

Sedentary time is associated with the metabolic syndrome in older adults with mobility limitations - The LIFE Study

Background: Epidemiological and objective studies report an association between sedentary time and lower risk of the metabolic syndrome (MetS) and its risk factors in young and middle-age adults. To date, there is a lack of objective data on the association between sedentary time and MetS among older adults. Methods: The association between objectively measured sedentary time (accelerometry) with MetS and MetS components was examined in a large sample of older adults with mobility limitations (N=1198; mean age=78.7. ±5.3years) enrolled in the Lifestyle Interventions and Independence for Elders (LIFE) study. Participants were divided into tertiles according to percentage of daily sedentary time, and the relation between sedentary time with MetS and MetS components was examined after adjusting for age, sex, ethnicity, and BMI. Results: Participants in the highest sedentary time tertile had significantly higher odds of MetS (OR=1.54) (95% CI 1.13 to 2.11) in comparison with participants in the lowest tertile (p=0.03). Participants in the highest sedentary time tertile had larger waist circumference (p=0.0001) and lower HDL-C (p=0.0003) than participants in the lowest sedentary time tertile. Conclusions: Sedentary time was strongly related to higher odds of MetS. These results, based on objectively measured sedentary time, suggest that sedentary time may represent an important risk factor for the development of MetS in older adults with high likelihood for disability