Damien Contou1,2,3, Florence Canoui-Poitrine4,5, Rémi Coudroy6, Sébastien Préau7, Martin Cour8, François Barbier9, Nicolas Terzi10, Guillaume Schnell11, Arnaud Galbois12, Lara Zafrani13, Benjamin Zuber14, Stephan Ehrmann15, Elodie Gelisse16, Delphine Colling17, Matthieu Schmidt18, Samir Jaber19, Alexandre Conia20, Romain Sonneville21, Gwenhaël Colin22, Laurent Guérin23, Damien Roux24, Sébastien Jochmans25, Nancy Kentish-Barnes26, Etienne Audureau4,5, Richard Layese4,5, Aline Alves1, Rachida Ouedraogo1, Christian Brun-Buisson1, Armand Mekontso Dessap1,3, Nicolas de Prost1,3. 1. Service de Réanimation Médicale, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil. 2. Service de Réanimation Polyvalente, Centre Hospitalier Victor Dupouy, Argenteuil. 3. Groupe de Recherche Clinique Cardiovascular and Respiratory Manifestations of Acute lung injury and Sepsis (CARMAS), Université Paris Est-Créteil. 4. Service de Santé Publique, Hôpital Henri-Mondor, AP-HP. 5. Université Paris-Est, Clinical Epidemiology and Aging Unit, Créteil. 6. Service de réanimation médicale, Centre Hospitalier Universitaire de Poitiers, Institut National de la Santé et de la Recherche Médicale (INSERM) Centre d'Investigation Clinique 1402, Acute Lung Injury and Ventilation Group, Université de Poitiers. 7. Service de réanimation médicale, Centre hospitalier régional universitaire de Lille. 8. Réanimation Médicale, Hospices Civils de Lyon-Groupement Hospitalier Edouard Herriot. 9. Service de réanimation médicale, Centre Hospitalier Régional d'Orléans. 10. Service de réanimation médicale, Centre Hospitalier Universitaire Grenoble Alpes, La Tronche. 11. Service de réanimation médico-chirurgicale, Groupe Hospitalier Le Havre. 12. Service de réanimation médico-chirurgicale, Hôpital Claude Galien, Quincy-sous-Sénart. 13. Service de réanimation médicale, Hôpital Saint-Louis, AP-HP, Paris. 14. Service de réanimation médico-chirurgicale, Centre Hospitalier André Mignot, Le Chesnay. 15. Service de Réanimation Médicale, Centre Hospitalier Régional Universitaire, Tours. 16. Service de réanimation médico-chirurgicale, Centre Hospitalier Universitaire de Reims. 17. Service de réanimation médico-chirurgicale, Centre hospitalier de Roubaix. 18. Service de Réanimation médicale, Centre Hospitalier Universitaire Pitié-Salpétrière, AP-HP, Paris. 19. Service de Réanimation médico-chirurgicale, Centre Hospitalier Universitaire de Montpellier. 20. Service de Réanimation médico-chirurgicale, Centre Hospitalier de Chartres. 21. Service de Réanimation Médicale, Hôpital Bichat Claude Bernard, AP-HP, Paris. 22. Service de réanimation médico-chirurgicale, Centre Hospitalier Départemental de Vendée, La Roche-sur-Yon. 23. Service de réanimation médico-chirurgicale, Hôpital Ambroise Paré, Boulogne-Billancourt. 24. Service de Médecine Intensive et Réanimation, Centre Hospitalier Universitaire Louis Mourier, AP-HP, Colombes. 25. Service de réanimation polyvalente, Centre Hospitalier de Melun. 26. Groupe de recherche Famiréa, Hôpital Saint-Louis, AP-HP, Paris, France.
Abstract
BACKGROUND: Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated. METHODS: This was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36) questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale-Revised (IES-R), and the activity of daily living (ADL) and instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire. RESULTS: Thirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 (interquartile range [IQR], 35-83) months and 44 (IQR, 35-72) months, respectively, of ICU discharge (P = .23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36-53] vs 54 [IQR, 36-57]; P = .18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n = 12/37 [32%]) exhibited lower PCS (34 [IQR, 24-38] vs 52 [IQR, 42-56]; P = .001) and IADL scores (7 [IQR, 4-8] vs 8 [IQR, 7-8]; P = .021) compared with nonamputated patients. CONCLUSIONS: Long-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health. CLINICAL TRIALS REGISTRATION: NCT03216577.
BACKGROUND: Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated. METHODS: This was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36) questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale-Revised (IES-R), and the activity of daily living (ADL) and instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire. RESULTS: Thirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 (interquartile range [IQR], 35-83) months and 44 (IQR, 35-72) months, respectively, of ICU discharge (P = .23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36-53] vs 54 [IQR, 36-57]; P = .18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n = 12/37 [32%]) exhibited lower PCS (34 [IQR, 24-38] vs 52 [IQR, 42-56]; P = .001) and IADL scores (7 [IQR, 4-8] vs 8 [IQR, 7-8]; P = .021) compared with nonamputated patients. CONCLUSIONS: Long-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health. CLINICAL TRIALS REGISTRATION: NCT03216577.
Authors: Sabri Soussi; Divya Sharma; Peter Jüni; Gerald Lebovic; Laurent Brochard; John C Marshall; Patrick R Lawler; Margaret Herridge; Niall Ferguson; Lorenzo Del Sorbo; Elodie Feliot; Alexandre Mebazaa; Erica Acton; Jason N Kennedy; Wei Xu; Etienne Gayat; Claudia C Dos Santos Journal: Crit Care Date: 2022-04-21 Impact factor: 19.334