Mental health in the first year after ICU-treated sepsis: Analysis of administrative diagnoses in German health claims data

Abstract

We aimed to quantify the (co-)occurrence of and risk factors for mental health impairments (MHI) in a cohort of sepsis survivors within 12 months after ICU stay in Germany. Population-based cohort study using nationwide de-identified health claims data of the German AOK health insurance. Patients with sepsis hospitalization and ICU treatment were identified by ICD-10 and procedural codes. Among 12-months survivors, we assessed new and prevalent MHI by ICD-10 diagnoses in the outpatient and inpatient health sector. Risk factors for MHI were assessed by multiple logistic regression analyses. Of 21,980 sepsis survivors, 54.8 % were diagnosed with any MHI in the 12 months post-discharge. 25.4 % of patients without pre-existing MHI had a new MHI diagnosis. Co-occurrence of MHI was common. Pre-existing depression, anxiety disorder, PTSD, substance use disorder and sleep disorder significantly increased the odds for a diagnosis of any MHI post-sepsis between six- and nine-fold, while treatment-related factors had no influence. MHI is common among sepsis survivors, particularly in those affected by any pre-existing psychological diagnoses. Early assessment of pre-existing psychopathology might help to identify patients at risk for prevention or treatment interventions. • Administrative diagnoses are used to quantify the prevalence and incidence of mental disorders after ICU treated sepsis. • In the first year after sepsis, every second survivor is affected by mental health impairments. • Depression is the most common diagnosis in the first year after surviving sepsis. • One in four survivors without a prior mental health disease has a new mental health diagnosis in the first year after sepsis. • ICU-treated sepsis survivors showed higher prevalence and incidence rates than hospitalized sepsis patients without ICU care.

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