The following are the most important diseases or complications that may be contributed to by sepsis (blood poisoning):
Respiratory system (J00-J99)
- Acute respiratory distress syndrome (ARDS) – acute progressive respiratory failure.
- Arterial or venous thrombosis, in patients with preoperative sepsis.
- Arterial hypoxemia (lowered partial pressure of oxygen in arterial blood) – paO2 < 75 mmHg under room air; paO2/FiO2 < 250 mmHg under oxygen application.
Blood, hematopoietic organs – immune system (D50-D90).
- Disseminated intravascular coagulation; disseminated intravascular coagulation (DIC syndrome, abbreviated as DIC; consumption coagulopathy) – acute onset coagulopathy caused by excessive activation of coagulation.
- Alteration in platelet (thrombocyte) count – < 100,000/μl or drop > 30%/24 h.
Endocrine, nutritional, and metabolic diseases (E00-E90).
- Metabolic acidosis (metabolic acidosis) with a base excess < 5 mmol/l or lactate > 1.5 x above the reference range
Cardiovascular System (I00-I99).
- Acute right heart failure (RHV).
- Apoplexy (stroke) – esp. high risk in the first week after hospital discharge
- Endocarditis (inflammation of the inner lining of the heart)
- Cardiovascular disease (coronary artery disease/coronary artery disease, apoplexy/stroke) – risk increased by a factor of 6 in the first year; by a factor of 2.47 and 2.12 in the second and third years; ≥ 5 years: increased by a factor of 1.87
- Myocardial infarction (heart attack) – bes. high risk in the first week after hospital discharge.
- Atrial fibrillation (VHF) (separate complication entity; VHF 8% in sepsis, 10% in severe sepsis, and 23% in patients in septic shock).
Psyche – Nervous System (F00-F99; G00-G99).
- Disturbances of consciousness – confusion, agitation, delirium.
- Critical illness neuropathy (CIP) – disease of the peripheral nervous system associated with multiple neurologic symptoms; CIP often occurs in association with severe illness requiring intensive care; major causes include sepsis, multiple organ failure, and long-term ventilations
- Epilepsy (seizures) – risk of epileptic seizures increased four- to fivefold in subsequent years, and even if no neurologic complications occurred during sepsis
Symptoms and abnormal clinical and laboratory parameters not elsewhere classified (R00-R99)
- Cachexia (emaciation; very severe emaciation).
- Septic shock; this is present when, despite adequate volume therapy, persistent arterial hypotension (sustained high blood pressure) with the need for therapy with vasopressors (substances designated to raise or support blood pressure) to achieve a mean arterial blood pressure of ≥ 65 mmHg. At the same time, the serum lactate value must be > 2 mmol/l [guidelines: S3 guideline].
Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).
- Renal dysfunction:
- Hourly diuresis (hourly excretion) of < 0.5 ml/kg bw/h for at least 2 h with adequate volume administration or
- Increase in serum creatinine > 2 times above the reference range.
Further
- Multi-organ failure (MODS, Multi organ dysfunction syndrome; MOF: Multi organ failure) – simultaneous or sequential failure or severe functional impairment of various vital organ systems of the body.
- Increased mortality (death rate) – 2 years continues to be increased after sepsis; absolute risk increase of 22.1% and a relative increase of 2.2-fold; independent of origin of sepsis, sex, age, and comorbidities (concomitant diseases)
Prognostic factors
- The one-year mortality rate (death rate) was 41% lower in obese patients (54% lower in extreme obese patients) than in normal-weight patients.
- Diabetes mellitus type 1 + 2 (type 1 diabetes tenfold, type 2 diabetics twofold increased mortality rate).
