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The impact of severe sepsis on health-related quality of life: a long-term follow-up study.
Anesth Analg. 2008 Dec; 107(6):1957-64.A&A

Abstract

BACKGROUND

Severe sepsis is frequently complicated by organ failure and accompanied by high mortality. Patients surviving severe sepsis can have impaired health-related quality of life (HRQOL). The time course of changes in HRQOL in severe sepsis survivors after discharge from the intensive care unit (ICU) and during a general ward stay have not been studied.

METHODS

We performed a long-term prospective study in a medical-surgical ICU. Patients with severe sepsis (n = 170) admitted for >48 h were included in the study. We used the Short-form 36 to evaluate the HRQOL of severe sepsis patients before ICU and hospital stay and at 3 and 6 mo after ICU discharge. Furthermore, we compared the results for ICU admission and 6 mo after ICU discharge with those of an age-matched general Dutch population.

RESULTS

At 6 mo after ICU discharge, 95 patients could be evaluated (eight patients were lost to follow-up, 67 died). HRQOL showed a multidimensional decline during the ICU stay and gradual improvement over the 6 mo after ICU discharge for the social functioning, vitality, role-emotional, and mental health dimensions. However, 6 mo after ICU discharge, scores for the physical functioning, role-physical, and general health dimensions were still significantly lower than preadmission values. Physical and Mental Component Scores changed significantly over time. In particular, the Mental Component Score showed a small decline at ICU discharge but recovered rapidly, and at 6 mo after ICU discharge had improved to near normal values. In addition, Short-form 36 scores were lower than those in a matched general population in six of the eight dimensions, with the exception of social functioning and bodily pain. Interestingly, the preadmission HRQOL in surviving patients was already lower in three of the eight dimensions (role-physical, mental health, and vitality) when compared with the general population.

CONCLUSIONS

Severe sepsis patients demonstrate a sharp decline of HRQOL during ICU stay and a gradual improvement during the 6 mo after ICU discharge. Recovery begins after ICU discharge to the general ward. Nevertheless, recovery is incomplete in the physical functioning, role-physical, and general health dimensions at 6 mo after ICU discharge compared with preadmission status.

Authors+Show Affiliations

Department of Intensive Care, Gelre Hospital, Location Lukas, Apeldoorn, The Netherlands. j.hofhuis@gelre.nlNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19020144

Citation

Hofhuis, José G M., et al. "The Impact of Severe Sepsis On Health-related Quality of Life: a Long-term Follow-up Study." Anesthesia and Analgesia, vol. 107, no. 6, 2008, pp. 1957-64.
Hofhuis JG, Spronk PE, van Stel HF, et al. The impact of severe sepsis on health-related quality of life: a long-term follow-up study. Anesth Analg. 2008;107(6):1957-64.
Hofhuis, J. G., Spronk, P. E., van Stel, H. F., Schrijvers, A. J., Rommes, J. H., & Bakker, J. (2008). The impact of severe sepsis on health-related quality of life: a long-term follow-up study. Anesthesia and Analgesia, 107(6), 1957-64. https://doi.org/10.1213/ane.0b013e318187bbd8
Hofhuis JG, et al. The Impact of Severe Sepsis On Health-related Quality of Life: a Long-term Follow-up Study. Anesth Analg. 2008;107(6):1957-64. PubMed PMID: 19020144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of severe sepsis on health-related quality of life: a long-term follow-up study. AU - Hofhuis,José G M, AU - Spronk,Peter E, AU - van Stel,Henk F, AU - Schrijvers,Augustinus J P, AU - Rommes,Johannes H, AU - Bakker,Jan, PY - 2008/11/21/pubmed PY - 2008/12/31/medline PY - 2008/11/21/entrez SP - 1957 EP - 64 JF - Anesthesia and analgesia JO - Anesth Analg VL - 107 IS - 6 N2 - BACKGROUND: Severe sepsis is frequently complicated by organ failure and accompanied by high mortality. Patients surviving severe sepsis can have impaired health-related quality of life (HRQOL). The time course of changes in HRQOL in severe sepsis survivors after discharge from the intensive care unit (ICU) and during a general ward stay have not been studied. METHODS: We performed a long-term prospective study in a medical-surgical ICU. Patients with severe sepsis (n = 170) admitted for >48 h were included in the study. We used the Short-form 36 to evaluate the HRQOL of severe sepsis patients before ICU and hospital stay and at 3 and 6 mo after ICU discharge. Furthermore, we compared the results for ICU admission and 6 mo after ICU discharge with those of an age-matched general Dutch population. RESULTS: At 6 mo after ICU discharge, 95 patients could be evaluated (eight patients were lost to follow-up, 67 died). HRQOL showed a multidimensional decline during the ICU stay and gradual improvement over the 6 mo after ICU discharge for the social functioning, vitality, role-emotional, and mental health dimensions. However, 6 mo after ICU discharge, scores for the physical functioning, role-physical, and general health dimensions were still significantly lower than preadmission values. Physical and Mental Component Scores changed significantly over time. In particular, the Mental Component Score showed a small decline at ICU discharge but recovered rapidly, and at 6 mo after ICU discharge had improved to near normal values. In addition, Short-form 36 scores were lower than those in a matched general population in six of the eight dimensions, with the exception of social functioning and bodily pain. Interestingly, the preadmission HRQOL in surviving patients was already lower in three of the eight dimensions (role-physical, mental health, and vitality) when compared with the general population. CONCLUSIONS: Severe sepsis patients demonstrate a sharp decline of HRQOL during ICU stay and a gradual improvement during the 6 mo after ICU discharge. Recovery begins after ICU discharge to the general ward. Nevertheless, recovery is incomplete in the physical functioning, role-physical, and general health dimensions at 6 mo after ICU discharge compared with preadmission status. SN - 1526-7598 UR - https://www.unboundmedicine.com/medline/citation/19020144/The_impact_of_severe_sepsis_on_health_related_quality_of_life:_a_long_term_follow_up_study_ L2 - https://doi.org/10.1213/ane.0b013e318187bbd8 DB - PRIME DP - Unbound Medicine ER -