{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T04:17:34Z","timestamp":1791433054252,"version":"4.3.3"},"reference-count":24,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000057","name":"National Institute of General Medical Sciences","doi-asserted-by":"publisher","award":["K08GM138825"],"award-info":[{"award-number":["K08GM138825"]}],"id":[{"id":"10.13039\/100000057","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Penn State Hershey Medical Center Department of Anesthesiology and Perioperative Medicine","award":["K08GM138825"],"award-info":[{"award-number":["K08GM138825"]}]},{"name":"Eberly Endowment Fund","award":["K08GM138825"],"award-info":[{"award-number":["K08GM138825"]}]},{"name":"TSF Cure Grant from the Pennsylvania Department of Public Health","award":["K08GM138825"],"award-info":[{"award-number":["K08GM138825"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic critical illness (CCI) is a syndrome characterized by persistent organ dysfunction that requires critical care therapy for \u226514 days. Sepsis and respiratory failure constitute the two primary causes of CCI. A better understanding of this patient population and their clinical course may help to risk-stratify them early during hospitalization. Our objective was to identify whether the source of sepsis (medical versus surgical) affected clinical trajectory and prognosis in patients developing CCI. Materials and Methods: We describe a cohort of patients having acute respiratory failure and sepsis and requiring critical care therapy in the medical (MICU) or surgical (SICU) critical care units for \u226514 days. Given the relative infrequency of CCI, we use a case series design to examine mortality, functional status, and place of residence (home versus non-home) at one year following their index hospitalization. Results: In medical patients developing CCI (n = 31), the severity of initial organ dysfunction, by SOFA score, was significantly associated with the development of CCI (p = 0.002). Surgical patients with CCI (n = 7) experienced significantly more ventilator-free days within the first 30 days following sepsis onset (p = 0.004), as well as less organ dysfunction at day 14 post-sepsis (p &lt; 0.0001). However, one-year mortality, one-year functional status, and residency at home were not statistically different between cohorts. Moreover, 57% of surgical patients and 26% of medical patients who developed CCI were living at home for one year following their index hospitalization (p = 0.11). Conclusions: While surgical patients who develop sepsis-related CCI experience more favorable 30-day outcomes as compared with medical patients, long-term outcomes do not differ significantly between groups. This suggests that reversing established organ dysfunction and functional disability, regardless of etiology, is more challenging compared to preventing these complications at an earlier stage.<\/jats:p>","DOI":"10.3390\/medicina59091617","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T09:51:37Z","timestamp":1694080297000},"page":"1617","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Comparing Long-Term Prognosis in Chronic Critically Ill Patients: A Case Series Study of Medical versus Surgical Sepsis"],"prefix":"10.3390","volume":"59","author":[{"given":"Benjamin","family":"Mancini","sequence":"first","affiliation":[{"name":"Penn State College of Medicine, 500 University Dr., Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiabin","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY 10021, USA"},{"name":"Department of Anesthesiology, Weill Cornell Medical College, New York, NY 10021, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Samuelsen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Division of Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judie A.","family":"Howrylak","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Schultz","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9596-001X","authenticated-orcid":false,"given":"Anthony S.","family":"Bonavia","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Division of Critical Care Medicine, Penn State Hershey Medical Center, 500 University Dr., Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1056\/NEJMoa010307","article-title":"Early goal-directed therapy in the treatment of severe sepsis and septic shock","volume":"345","author":"Rivers","year":"2001","journal-title":"N. 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