%0 Journal Article %J Chest %D 2020 %T Changes in Self-Rated Health After Sepsis in Older Adults: A Retrospective Cohort Study. %A Carey, Matthew R %A Hallie C Prescott %A Theodore J Iwashyna %A Wilson, Michael E %A Angela Fagerlin %A Valley, Thomas S %K Aging %K health-related quality of life %K Quality of Life %K Sepsis %X

BACKGROUND: As more individuals survive sepsis, there is an urgent need to understand its effects on patient-reported outcomes.

RESEARCH QUESTION: What is the effect of sepsis on self-rated health, and what role, if any, does functional disability play in mediating this effect?

STUDY DESIGN AND METHODS: We conducted a survey- and administrative claims-based retrospective cohort study using the US Health and Retirement Study, a nationally representative cohort-based survey of older adults in the United States, from 2000 through 2016. We matched Medicare beneficiaries hospitalized with sepsis in 2000 to 2008 to nonhospitalized individuals. Self-rated health and functional disability were tracked biannually for 8 years. Differences in self-rated health between the cohorts were measured using mixed models with and without controlling for changes in functional disability.

RESULTS: Seven hundred fifty-eight individuals with sepsis were matched 1:1 to 758 nonhospitalized individuals, all aged 65 years and older. Among survivors, sepsis was associated with worse self-rated health in years 2 and 4 (adjusted absolute difference in self-rated health on a 5-point scale in year 2: -0.24 [95% CI, -0.38 to -0.10] and year 4: -0.17 [95% CI, -0.33 to -0.02]) but not in years 6 or 8. After accounting for changes in functional status, the association between sepsis and self-rated health was still present but reduced in year 2 (adjusted absolute difference in self-rated health, -0.18 [95% CI, -0.31 to -0.05]) and was not present in years 4, 6, or 8.

INTERPRETATION: Self-rated health worsened initially after sepsis but returned to the level of that of nonhospitalized control subjects by year 6. Mitigating sepsis-related functional disability may play a key role in improving self-rated health after sepsis.

%B Chest %V S0012-3692 %P 31732-3 %8 2020 Nov %G eng %N 20 %R 10.1016/j.chest.2020.05.606