Bruno Pastene1, Raphaël Cinotti2,3, Etienne Gayat2,3, Jacques Duranteau4, Qin Lu5, Philippe Montravers6, Sébastien Pili-Floury7, Isabelle Rennuit8, Alexandre Mebazaa2,3, Marc Leone9. 1. Service d'Anesthésie et de Réanimation, Hôpital Nord, Aix Marseille Université, Assistance Publique Hôpitaux de Marseille, Marseille, France. bruno.pastene@ap-hm.fr. 2. Département d'Anesthésie-Réanimation, Hôpitaux Universitaires Saint-Louis, Lariboisière, Assistance Publique Hôpitaux de Paris, Paris, France. 3. Biomarkers in CArdio-Neuro-VAScular Diseases (bioCANVAS), UMR-S 942, Inserm, Paris, France. 4. Service de Réanimation Chirurgicale, Hôpital Bicêtre, Assistance Publiques Hôpitaux de Paris, Paris, France. 5. Service de Réanimation Chirurgicale, Hôpital Universitaire Pitié-Salpêtrière, Assistance Publiques Hôpitaux de Paris, Paris, France. 6. Service de Réanimation Chirurgicale, Hôpital Bichat-Claude Bernard, Assistance Publiques Hôpitaux de Paris, Paris, France. 7. Service de Réanimation Chirurgicale, Centre Hospitalier Universitaire de Besançon, Besançon, France. 8. Service de Réanimation Polyvalente, Hôpital Beaujon, Assistance Publiques Hôpitaux de Paris, Paris, France. 9. Service d'Anesthésie et de Réanimation, Hôpital Nord, Aix Marseille Université, Assistance Publique Hôpitaux de Marseille, Marseille, France.
Abstract
INTRODUCTION: The long-term outcomes of intensive care unit (ICU) patients are known to be worse than those of the general population, but they are poorly known in severe trauma patients. We conducted an ancillary examination of the FROG-ICU study to identify risk factors and biomarkers associated with the poorer long-term outcomes and mortality in trauma ICU patients. METHODS: Mortality, quality of life (QoL) and stress level scores were obtained 1 year after discharge from ICU. Blood samples were collected at ICU admission and discharge for measurement of inflammatory and cardiovascular biomarkers. RESULTS: ICU trauma patients had a significantly lower 1-year mortality than non-trauma patients (7% vs. 23%, p < 0.001), but had worse stress levels scores (19 vs. 13, p = 0.041). No difference was found regarding physical and mental QoL scores (33 vs. 31, p = 0.19 and 30 vs. 28, p = 0.42). Patients with better QoL scores had lower tracheotomy rates (11% vs. 30%, p = 0.01). Worse stress level scores are associated with poor QoL scores and vice versa. Some study biomarkers were significantly higher in those ICU trauma patients who had worse QoL scores at 1 year after discharge. DISCUSSION: Our study suggests that quality of life 1 year after an ICU stay is poor and is similar in both trauma and non-trauma patients, but ICU trauma patients are at greater risk of developing post-traumatic stress disorder-related symptoms. Tracheotomy and high levels of inflammatory biomarkers could be associated with impaired quality of life.
INTRODUCTION: The long-term outcomes of intensive care unit (ICU) patients are known to be worse than those of the general population, but they are poorly known in severe traumapatients. We conducted an ancillary examination of the FROG-ICU study to identify risk factors and biomarkers associated with the poorer long-term outcomes and mortality in trauma ICUpatients. METHODS: Mortality, quality of life (QoL) and stress level scores were obtained 1 year after discharge from ICU. Blood samples were collected at ICU admission and discharge for measurement of inflammatory and cardiovascular biomarkers. RESULTS:ICU traumapatients had a significantly lower 1-year mortality than non-traumapatients (7% vs. 23%, p < 0.001), but had worse stress levels scores (19 vs. 13, p = 0.041). No difference was found regarding physical and mental QoL scores (33 vs. 31, p = 0.19 and 30 vs. 28, p = 0.42). Patients with better QoL scores had lower tracheotomy rates (11% vs. 30%, p = 0.01). Worse stress level scores are associated with poor QoL scores and vice versa. Some study biomarkers were significantly higher in those ICU traumapatients who had worse QoL scores at 1 year after discharge. DISCUSSION: Our study suggests that quality of life 1 year after an ICU stay is poor and is similar in both trauma and non-traumapatients, but ICU traumapatients are at greater risk of developing post-traumatic stress disorder-related symptoms. Tracheotomy and high levels of inflammatory biomarkers could be associated with impaired quality of life.
Entities:
Keywords:
Biomarker; Intensive care unit; Post-traumatic stress disorder; Quality of life; Severe trauma
Authors: Matthias A Zumstein; Mario Moser; Matthias Mottini; Sebastian R Ott; Charlotte Sadowski-Cron; Bogdan P Radanov; Heinz Zimmermann; Aristomenis Exadaktylos Journal: J Trauma Date: 2011-07
Authors: Ewa Baum; Krzysztof Pawlaczyk; Beata Maćkowiak; Patrycja Sosinska; Monika Matecka; Barbara Kolodziejczak; Michał Musielak; Andrzej Breborowicz Journal: Int J Clin Exp Pathol Date: 2015-10-01