Grant: CIHR Fellowship

The term sepsis is used to label severe infections that may produce widespread consequences. These are produced by the infection itself and the patient's response. Sepsis can result in the failure of everyday body functions, such as hypotension and injury to the kidneys, and up to 1 in 3 patients with severe infection may die within the first hospitalization. In addition, patients that survive severe infections may face long term consequences such as a decreased overall health condition and an increased risk of stroke and heart attacks. Elderly patients may be at higher risk of such consequences due to multiple factors including chronic diseases and the use of different medications to treat them. Moreover, the effect of sepsis on other related long term consequences such as the occurrence of clots in deep veins of legs or lungs remains unknown. Furthermore, there is not enough data on specific factors associated with these long term consequences in patients that survive a severe infection. Hence, the better delineation of both the burden and trends of long term effects of sepsis and the identification of subgroups of patients that may be at higher risk may aid in the clinical decision making process and the rational design of future studies. In addition, identifying potential therapies and ways to modify such risk may also prove relevant for clinical practice and patient centered treatment and outcomes. Hence, the present research proposal seeks to: 1) describe the occurrence and time trends of long term consequences (including stroke, heart attacks, kidney injury and venous clot formation) after severe infection in critically ill patients in Ontario, 2) identify factors that may help in the identification of patients at higher risk of these outcomes, with focus on baseline characteristics and the use of both chronic and new medications, 3) identify potential interventions that may reduce the overall long term consequences of severe infection among adult patients.