Abstract
Abstract Introduction: Severe sepsis may be accompanied by long-term sequelae, and physical aspects related to physical fitness and physical function of sepsis survivors after discharge are still poorly explored. Objective: This is an integrative review aimed at analyzing if sepsis survivors present impairment of the physical fitness components and/or physical conditioning and physical function after hospital discharge. Methods: The search was performed in six electronic databases: LILACS, PubMed, CINAHL, Cochrane Library, Web of Science and Scopus. Controlled descriptors (Sepsis, Septic Shock, Physical Fitness and Activities of Daily Living) and uncontrolled descriptors or keywords (Severe Sepsis, Physical Function, and Physical Status) were used. Results: The search resulted in a total of 434 articles, of which seven were eligible for analysis. Of these, none applied a specific physical test to assess the components of physical fitness. Regarding physical function, it was verified that four studies applied specific tests to evaluate the activities of daily living. However, it was observed in most of the studies that the physical aspects were only subjectively assessed through health-related quality of life questionnaires. Overall, all studies analyzed showed that the health-related quality of life of sepsis survivors may be impaired after long periods of hospital discharge. Conclusion: Most sepsis survivors presented impairments related to physical fitness and physical function after hospital discharge, as they showed impairments in their functional autonomy, resulting in loss of independence and autonomy in performing the activities of daily living.
Highlights
Severe sepsis may be accompanied by long-term sequelae, and physical aspects related to physical fitness and physical function of sepsis survivors after discharge are still poorly explored
Survivors of severe sepsis still had their reduced among patients with septic shock compared health-related quality of life impaired, even up to six to the control group (65 vs 90, P < 0.0001)
Severe sepsis may result in a patients (47/70) reported a significant deterioration of physical function compared to pre-hospitalization status. 81% (38/47) of the patients attributed the decrease in physical fitness to loss of muscle mass
Summary
Severe sepsis may be accompanied by long-term sequelae, and physical aspects related to physical fitness and physical function of sepsis survivors after discharge are still poorly explored. It was verified that four studies applied specific tests to evaluate the activities of daily living It was observed in most of the studies that the physical aspects were only subjectively assessed through healthrelated quality of life questionnaires. Conclusion: Most sepsis survivors presented impairments related to physical fitness and physical function after hospital discharge, as they showed impairments in their functional autonomy, resulting in loss of independence and autonomy in performing the activities of daily living. When sepsis progresses to dysfunction of one or more organs it is called severe sepsis and septic shock if there is hypotension that does not respond to aggressive fluid replacement, needing administration of vasoactive agents to maintain blood pressure at compatible levels with life The latter condition is notably a marker of poor prognosis, significantly interfering with the outcome of patients with infection [1]. A general mortality rate of approximately 46.6% was observed in the short term, and when the subgroups sepsis, severe sepsis and septic shock were observed, mortality was 16.7%, 34.4% and 65.3%, respectively [5]
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