Mental disorders protect against sepsis death

Sepsis patients with mental disorders see lowered rates of short-term mortality, a recent study has found.

The study included 283,025 hospitalized patients with sepsis, of whom 20.1 percent (n=56,904) had been diagnosed with mental disorders using Clinical Classification Software codes. Propensity score matching yielded 50,174 pairs of sepsis patients with and without mental disorders.

Among patients with mental disorders, mood (66.0 percent) and anxiety (48.4 percent) disorders were the most common types. Crude analysis found that short-term mortality was substantially lower among hospitalized sepsis patients with mental disorders (25.0 percent vs 32.8 percent).

Notably, multivariable logistic regression analysis confirmed such a protective effect, such that those with mental disorders saw a significant 21-percent decrease in the risk of short-term mortality (adjusted odds ratio [OR], 0.792, 95 percent confidence interval [CI], 0.772–0.812).

Moreover, disaggregating according to the class of mental disorder found a consistent effect across all categories: anxiety (adjusted OR, 0.8325, 95 percent CI, 0.8046–0.8613), mood (adjusted OR, 0.7781, 95 percent CI, 0.7552–0.8017), personality (adjusted OR, 0.4509, 95 percent CI, 0.3046–0.6671), and psychotic (adjusted OR, 0.7398, 95 percent CI, 0.6889–0.7944; p<0.001 for all) disorders.

Similarly, mental disorders led to significant survival benefits among sepsis patients in intensive care (adjusted OR, 0.797, 95 percent CI, 0.769–0.826) and with septic shock (adjusted OR, 0.762, 95 percent CI, 0.7390–0.785).

“Further studies are needed to both corroborate our findings and to examine sepsis-associated changes across immune function domains in patients with and without mental disorders to further inform strategies to improve sepsis outcomes,” the researchers said.