Quality of Life of Sepsis Survivors*

Abstract

OBJECTIVE: To determine the differences between the quality of life for sepsis and nonsepsis survivors, factors affecting the quality of life for sepsis survivors, and their changes over time. DESIGN: A prospective longitudinal study with a quantitative comparative design. SETTING: A university hospital in the greater Tokyo area of Japan. PATIENTS: The study included 41 and 40 patients in the sepsis and nonsepsis groups, respectively. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Health-related quality of life (HRQOL), independence in activities of daily living (ADL), stress levels, and spirituality were compared between the sepsis and nonsepsis groups at ICU discharge, hospital discharge, and 1 month after discharge. Comparison of HRQOL between the sepsis and nonsepsis groups showed significantly low HRQOL in the sepsis group compared with the nonsepsis group at ICU discharge and hospital discharge. Factors such as stress levels and spirituality affected the HRQOL in the nonsepsis group at ICU discharge. At discharge, stress and spirituality affected HRQOL in both the sepsis and nonsepsis groups. One month after discharge, ADL, stress, and spirituality affected HRQOL in both the sepsis and nonsepsis groups. In terms of changes over time, HRQOL at ICU discharge in the sepsis group was significantly lower than at discharge and 1 month after discharge. The two-way analyses of variance showed no interactions between the groups and time regarding HRQOL. CONCLUSIONS: HRQOL of sepsis survivors was significantly lower than that of nonsepsis survivors. ADL and stress influenced HRQOL. The study suggests the importance of ADL training and stress alleviation during the ICU stay.

Life After Sepsis: The Journey Continues*

“…In this issue of Critical Care Medicine , Kurematsu and Ikematsu (10) report the differences between the QOL for sepsis and nonsepsis survivors. The study explored factors affecting the QOL of sepsis survivors over time.…”

“…The single center study was conducted in Japan at a University hospital. The authors analyzed the two groups (sepsis and nonsepsis) using a prospective longitudinal design with a quantitative comparative design (10). All ICU patients admitted during November 6, 2019, and July 31, 2021, were included in the sample size with 41 patients with sepsis and 40 without sepsis selected for the study.…”

“…Patients were selected for the sepsis group based on an increase of two or more points in the Sequential Organ Failure Assessment (SOFA) score and clinical findings, or quick-SOFA if they were already outside the ICU. Additional criteria included age equal to or greater than 20, ability to understand Japanese, conscious state of 15 points on the Glasgow Coma Scale after recovery from sepsis, and independence in activities of daily living (ADLs) before the onset of their sepsis diagnosis (10). Patients screened and found without sepsis were included in the nonsepsis group.…”

“…The authors defined QOL using these validated questionnaires that were well selected to be culturally sensitive for the population being tested. Stress levels were measured using the IES-R-J, which was developed to measure posttraumatic stress syndrome (10, 12).…”

“…Looking at 1 month after discharge, ADLs ( p = 0.023 vs p = 0.021), stress ( p = 0.002 vs p = 0.037), and spirituality ( p = 0.018 vs p = 0.029) affected HRQOL in both groups. The study by Kurematsu and Ikematsu (10) was one medical center; however, there are several learnings we can take away from the results. First, the authors used valid scales and tools (questionnaires) to assess the impact and changes over time on HRQOL.…”