Abstract
The objective of the present study was to compare the health-related quality of life (HR-QoL) of survivors from severe sepsis and septic shock with HR-QoL in others who survived critical illness not involving sepsis. From March 1997 to March 2001, adult patients in an eight-bed medical/surgical intensive care unit (ICU) of a tertiary care hospital admitted with severe sepsis or septic shock (sepsis group; n = 305) were enrolled and compared with patients admitted without sepsis (control group; n = 392). Patients younger than 18 years (n = 48) and those whose ICU stay was 1 day or less (n = 453) were excluded. In addition, patients exhibiting nonsevere sepsis on admission were excluded (n = 87). Finally, patients who developed nonsevere sepsis or severe sepsis/septic shock after admission were also excluded (n = 88). In-hospital mortality rates were 34% in the sepsis group and 26% in the control group. There were no differences in sex, age, main activity (work status), and previous health state between groups. Survivors in the sepsis group had a significantly higher Acute Physiology and Chronic Health Evaluation II score on admission (17 versus 12) and stayed significantly longer in the ICU. A follow-up appointment was held 6 months after ICU discharge, and an EQ-5D (EuroQol five-dimension) questionnaire was administered. A total of 104 sepsis survivors and 133 survivors in the control group answered the EQ-5D questionnaire. Sepsis survivors reported significantly fewer problems only in the anxiety/depression dimension. Although there were no significant differences in the other dimensions of the EQ-5D, there was a trend towards fewer problems being reported by sepsis survivors. Evaluation using the EQ-5D at 6 months after ICU discharge indicated that survivors from severe sepsis and septic shock have a similar HR-QoL to that of survivors from critical illness admitted without sepsis.
Highlights
The objective of the present study was to compare the health-related quality of life (HR-QoL) of survivors from severe sepsis and septic shock with HR-QoL in others who survived critical illness not involving sepsis
Patients From March 1997 to March 2001, all adult patients in an eight-bed medical/surgical intensive care unit (ICU) of a tertiary care hospital who were admitted with severe sepsis or septic shock were enrolled and compared with patients admitted without sepsis
Patients in the sepsis group were those in whom severe sepsis and septic shock was the reason for admission to the ICU, according to the criteria defined by the 2001 International Sepsis Definitions Conference [21]: patients with severe sepsis were those admitted with sepsis complicated by organ dysfunction; and patients with septic shock were those with sepsis and persistent arterial hypotension despite adequate volume resuscitation
Summary
The objective of the present study was to compare the health-related quality of life (HR-QoL) of survivors from severe sepsis and septic shock with HR-QoL in others who survived critical illness not involving sepsis. Patients who developed nonsevere sepsis or severe sepsis/septic shock after admission were excluded (n = 88). There were no differences in sex, age, main activity (work status), and previous health state between groups. Survivors in the sepsis group had a significantly higher Acute Physiology and Chronic Health Evaluation II score on admission (17 versus 12) and stayed significantly longer in the ICU. During the first year after an episode of sepsis mortality rates remain high, and the sepsis-associated risk for dying may persist up to 5 years after hospitalization [2]. This suggests that increased mortality persists for a number of years after an episode of sepsis, despite the acute nature of the disease process [6].
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