To analyze the interplay between sepsis and chronic diseases, integrating epidemiological, pathophysiological, and immunological perspectives to identify factors guiding personalized therapeutic interventions, particularly in patients with multimorbidity.
Key Findings:
Multimorbidity significantly increases the risk and severity of sepsis, particularly in conditions such as diabetes, heart failure, and COPD.
Chronic conditions like diabetes, heart failure, and COPD alter sepsis biology and outcomes, leading to increased mortality.
Mechanisms include low-grade inflammation, impaired immunity, endothelial injury, and neuroendocrine maladaptation, with specific examples of how these conditions interact.
Nosocomial sepsis contributes disproportionately to mortality, especially in ICU settings, highlighting the need for targeted interventions.
Survivors of sepsis often face long-term neurological and psychosocial issues, necessitating follow-up care.
Interpretation:
Understanding sepsis through the lens of multimorbidity allows for the development of personalized care strategies that can significantly reduce the long-term burden of sepsis on patients.
Limitations:
The review is narrative and may not encompass all recent studies, particularly those published in the last year.
Further research is needed to validate proposed frameworks and interventions, including specific areas where evidence is lacking.
Conclusion:
An integrative framework for understanding systemic vulnerability in sepsis can enhance personalized care and improve outcomes for patients with multimorbidity, emphasizing the need for tailored interventions.
by Jhan S. Saavedra-Torres, Humberto Alejandro Nati-Castillo, Alice Gaibor-Pazmiño, Wilder Fernando Ortiz Erazo, María Alejandra Martínez Castaño, Cristhian Camilo Nieto Brandon, Diana Catalina Parra Ramos, Juan Villamil, Leonardo Sánchez S., Andrés López-Cortés, Juan S. Izquierdo-Condoy
