Long-term quality of life after sepsis and predictors of quality of life in survivors with sepsis

Abstract

PurposeTo evaluate the quality of life among survivors after sepsis in 2 years, comparing with critical patients without sepsis and the general people, analyze the changes and the predictors of quality of life among septic survivors.MethodsThis prospective case-control study screened the intensive care unit (ICU) patients in Tianjin Third Central Hospital from January 2014 to October 2017, and the Chinese general population in the previous studies was also included. According to inclusion criteria and exclusion criteria, 306 patients with sepsis were enrolled as the observation group, and another 306 patients without sepsis in ICU during the same period, whose ages, gender and Charlson Comorbidity Index matched with observation group, were enrolled as the control group. At 3 mo, 12 mo, and 24 mo after discharge, the Mos 36-item Short Form Health Survey (SF-36), the Euroqol-5 dimension (EQ-5D), and the activities of daily living (ADL) were evaluated in face-to-face for the quality of life among survivors.ResultsThere were 210 (68.6%) septic patients and 236 (77.1%) non-septic critically ill patients surviving. At 3 months after discharge, the observation and control groups had the similar demographic characteristics (age: 58.8 ± 18.1years vs. 57.5 ± 17.6 years, p = 0.542; male: 52.0% vs. 51.4%, p = 0.926). However, the observation group had higher acute physiology and chronic health evaluation II (APACHEII) scores, higher sequential organ failure assessment (SOFA) scores, longer hospital stay, and longer ICU stay than the control group did (p < 0.05). There were no significant differences in the eight dimensions of the SF36 scale, the EQ-5D health utility scores, and the activities of daily life scores between septic survivors and non-septic survivors (p > 0.05). In addition, compared with the quality of life of the Chinese general population (aged 55–64 years), the quality of life of septic patients were significantly lower at 3 months after discharge (p < 0.05). Comparing the quality of life of the ill patients who had been discharged at 3 mo and 24 mo, the general health improved statistically (p = 0.000) and clinically (score improvement > 5 points). Older age (OR, 1.050; 95% CI, 1.022–1.078, p = 0.000), female (OR, 3.375; 95% CI, 1.434–7.941, p = 0.005) and longer mechanical ventilation time (OR, 3.412; 95% CI, 1.413, 8.244, p = 0.006) were the risk factors for the quality of life of septic survivors.ConclusionThe long-term quality of life of septic survivors was similar to that of non-sepsis critically ill survivors. After discharge, the general health of sepsis improved overtime. Age, female and mechanical ventilation time (>5 days) were the predictors of the quality of life after sepsis.

Prevalence of post intensive care syndrome among Japanese intensive care unit patients: A prospective, multicenter, observational J-PICS study

“…Table 2 shows the hospital outcomes and 6-month outcomes among the patients who were enrolled for assessment at 6 months after ICU admission. The median ICU length of stay, hospital length of stay, and duration of mechanical ventilation were 7 [5][6][7][8][9][10][11][12][13][14] [23.5-43], respectively (P<0.001), while it was 43 [40][41][42][43][44][45][46] and 43 [41][42][43][44][45], respectively (P=0.51), in non-PICS patients. Cognitive impairment, de ned by the worsening of SMQ score and SMQ score at 6 months < 40, occurred in 36 (37.5%) patients.…”

“…Five of the 16 ICUs were university-a liated hospitals, and the others were tertiary teaching hospitals. The median number of ICU beds was 10 [interquartile range (IQR), [8][9][10][11][12][13][14][15]. All ICUs were mixed ICUs and were managed by the intensivists.…”

“…Only a few studies focusing on the co-occurrence of PICS symptoms in individual patients have been conducted [6,7]. Second, limited data regarding PICS after implementation of PICS prophylaxis strategy are available, especially for Asian populations with different cultural backgrounds and races from Western countries [8][9][10][11]. Many guidelines and bundle strategies aimed at growing awareness about PICS have been published and implemented to decrease the occurrence of PICS.…”

Prevalence of Post Intensive Care Syndrome Among Japanese Intensive Care Unit Patients: A Prospective, Multicenter, Observational J-PICS Study

“…Five of the 16 ICUs were university-a liated hospitals and the others were tertiary teaching hospitals. The median number of ICU beds was 10 [interquartile range (IQR), [8][9][10][11][12][13][14][15]. All ICUs were mixed ICUs and were managed by intensivists.…”

“…Only a few studies focusing on the co-occurrence of PICS symptoms in individual patients have been conducted [6,7]. Second, limited data regarding PICS after implementation of PICS prophylaxis strategy are available, especially for Asian populations with different cultural backgrounds and races from Western countries [8][9][10][11]. Growing awareness about PICS; many guidelines and bundle strategies; clinical practice guidelines for the prevention and management of pain, agitation, sedation, delirium, immobility, and sleep disruption in adult patients in the ICU [12]; guidelines for family centered care in the neonatal, pediatric, and adult ICU [13]; and ABCDEFGH bundle [14] have been published and implemented to decrease the occurrence of PICS.…”