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Enhancing Recovery From Sepsis

Overview of attention for article published in JAMA: Journal of the American Medical Association, January 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

news
5 news outlets
blogs
1 blog
twitter
901 tweeters
facebook
15 Facebook pages
googleplus
4 Google+ users

Readers on

mendeley
127 Mendeley
citeulike
1 CiteULike
Title
Enhancing Recovery From Sepsis
Published in
JAMA: Journal of the American Medical Association, January 2018
DOI 10.1001/jama.2017.17687
Pubmed ID
Authors

Hallie C. Prescott, Derek C. Angus

Abstract

Survival from sepsis has improved in recent years, resulting in an increasing number of patients who have survived sepsis treatment. Current sepsis guidelines do not provide guidance on posthospital care or recovery. Each year, more than 19 million individuals develop sepsis, defined as a life-threatening acute organ dysfunction secondary to infection. Approximately 14 million survive to hospital discharge and their prognosis varies. Half of patients recover, one-third die during the following year, and one-sixth have severe persistent impairments. Impairments include development of an average of 1 to 2 new functional limitations (eg, inability to bathe or dress independently), a 3-fold increase in prevalence of moderate to severe cognitive impairment (from 6.1% before hospitalization to 16.7% after hospitalization), and a high prevalence of mental health problems, including anxiety (32% of patients who survive), depression (29%), or posttraumatic stress disorder (44%). About 40% of patients are rehospitalized within 90 days of discharge, often for conditions that are potentially treatable in the outpatient setting, such as infection (11.9%) and exacerbation of heart failure (5.5%). Compared with patients hospitalized for other diagnoses, those who survive sepsis (11.9%) are at increased risk of recurrent infection than matched patients (8.0%) matched patients (P < .001), acute renal failure (3.3% vs 1.2%, P < .001), and new cardiovascular events (adjusted hazard ratio [HR] range, 1.1-1.4). Reasons for deterioration of health after sepsis are multifactorial and include accelerated progression of preexisting chronic conditions, residual organ damage, and impaired immune function. Characteristics associated with complications after hospital discharge for sepsis treatment are not fully understood but include both poorer presepsis health status, characteristics of the acute septic episode (eg, severity of infection, host response to infection), and quality of hospital treatment (eg, timeliness of initial sepsis care, avoidance of treatment-related harms). Although there is a paucity of clinical trial evidence to support specific postdischarge rehabilitation treatment, experts recommend referral to physical therapy to improve exercise capacity, strength, and independent completion of activities of daily living. This recommendation is supported by an observational study involving 30 000 sepsis survivors that found that referral to rehabilitation within 90 days was associated with lower risk of 10-year mortality compared with propensity-matched controls (adjusted HR, 0.94; 95% CI, 0.92-0.97, P < .001). In the months after hospital discharge for sepsis, management should focus on (1) identifying new physical, mental, and cognitive problems and referring for appropriate treatment, (2) reviewing and adjusting long-term medications, and (3) evaluating for treatable conditions that commonly result in hospitalization, such as infection, heart failure, renal failure, and aspiration. For patients with poor or declining health prior to sepsis who experience further deterioration after sepsis, it may be appropriate to focus on palliation of symptoms.

Twitter Demographics

The data shown below were collected from the profiles of 901 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 127 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 127 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 22 17%
Other 21 17%
Student > Ph. D. Student 15 12%
Professor > Associate Professor 12 9%
Student > Master 11 9%
Other 46 36%
Readers by discipline Count As %
Medicine and Dentistry 65 51%
Unspecified 25 20%
Nursing and Health Professions 12 9%
Biochemistry, Genetics and Molecular Biology 5 4%
Agricultural and Biological Sciences 4 3%
Other 16 13%

Attention Score in Context

This research output has an Altmetric Attention Score of 558. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 June 2018.
All research outputs
#9,149
of 11,402,253 outputs
Outputs from JAMA: Journal of the American Medical Association
#269
of 23,336 outputs
Outputs of similar age
#650
of 292,420 outputs
Outputs of similar age from JAMA: Journal of the American Medical Association
#21
of 386 outputs
Altmetric has tracked 11,402,253 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 23,336 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 40.3. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 292,420 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 386 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.