TY - JOUR
T1 - Relationship between brain volume reduction during the acute phase of sepsis and activities of daily living in elderly patients
T2 - A prospective cohort study
AU - Hosokawa, Toru
AU - Kinoshita, Kosaku
AU - Ihara, Shingo
AU - Nakagawa, Katsuhiro
AU - Iguchi, Umefumi
AU - Hirabayashi, Marina
AU - Mutoh, Tomokazu
AU - Sawada, Nami
AU - Kuwana, Tsukasa
AU - Yamaguchi, Junko
N1 - Publisher Copyright:
© 2023 Hosokawa et al.
PY - 2023/5
Y1 - 2023/5
N2 - Brain damage in acute sepsis may be associated with poor long-term outcomes that impair reintegration into society. We aimed to clarify whether brain volume reduction occurs during the acute phase of sepsis in patients with acute brain damage. In this prospective, noninterventional observational study, brain volume reduction was evaluated by comparing head computed tomography findings at admission with those obtained during hospitalization. We examined the association between brain volume reduction and performance of the activities of daily living in 85 consecutive patients (mean age, 77 ± 12.7 years) with sepsis or septic shock. The bicaudate ratio increased in 38/58 (65.5%) patients, Evans index increased in 35/58 (60.3%) patients, and brain volume by volumetry decreased in 46/58 (79.3%) patients from the first to the second measurement, with significant increases in the bicaudate ratio (P < 0.0001) and Evans index (P = 0.0005) and a significant decrease in the brain volume by volumetry (P < 0.0001). The change rate for brain volume by volumetry was significantly correlated with the Katz index (ρ =-0.3790, P = 0.0094). In the acute phase of sepsis in this sample of older patients, 60-79% of patients showed decreased brain volumes. This was associated with a decreased capacity for performing activities of daily living.
AB - Brain damage in acute sepsis may be associated with poor long-term outcomes that impair reintegration into society. We aimed to clarify whether brain volume reduction occurs during the acute phase of sepsis in patients with acute brain damage. In this prospective, noninterventional observational study, brain volume reduction was evaluated by comparing head computed tomography findings at admission with those obtained during hospitalization. We examined the association between brain volume reduction and performance of the activities of daily living in 85 consecutive patients (mean age, 77 ± 12.7 years) with sepsis or septic shock. The bicaudate ratio increased in 38/58 (65.5%) patients, Evans index increased in 35/58 (60.3%) patients, and brain volume by volumetry decreased in 46/58 (79.3%) patients from the first to the second measurement, with significant increases in the bicaudate ratio (P < 0.0001) and Evans index (P = 0.0005) and a significant decrease in the brain volume by volumetry (P < 0.0001). The change rate for brain volume by volumetry was significantly correlated with the Katz index (ρ =-0.3790, P = 0.0094). In the acute phase of sepsis in this sample of older patients, 60-79% of patients showed decreased brain volumes. This was associated with a decreased capacity for performing activities of daily living.
UR - http://www.scopus.com/inward/record.url?scp=85159394329&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0284886
DO - 10.1371/journal.pone.0284886
M3 - Article
C2 - 37192211
AN - SCOPUS:85159394329
SN - 1932-6203
VL - 18
JO - PLoS ONE
JF - PLoS ONE
IS - 5 MAY
M1 - e0284886
ER -