Ya-Xiao Su,Lei Xu,Xin-Jing Gao,Zhi-Yong Wang,Xing Lu,Cheng-Fen Yin.[J].Chin J Traumatol,2018,21(4):216-223. 10.1016/j.cjtee.2018.05.001

Long-term quality of life after sepsis and predictors of quality of life in survivorswith sepsis

DOI：10.1016/j.cjtee.2018.05.001

KeyWord: SepsisSurvivorsLong-term quality of lifeRisk factors

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Author Name	Affiliation
Ya-Xiao Su	Department of Critical Care Medicine, The Third Central Hospital of Tianjin, Tianjin, 300170, China Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin, China Tianjin Institute of Hepatobiliary Disease, Tianjin, China
Lei Xu	Department of Critical Care Medicine, The Third Central Hospital of Tianjin, Tianjin, 300171, China Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin, China Tianjin Institu
Xin-Jing Gao	Department of Critical Care Medicine, The Third Central Hospital of Tianjin, Tianjin, 300172, China Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin, China Tianjin Institu
Zhi-Yong Wang	Department of Critical Care Medicine, The Third Central Hospital of Tianjin, Tianjin, 300173, China Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin, China Tianjin Institu
Xing Lu	Department of Critical Care Medicine, The Third Central Hospital of Tianjin, Tianjin, 300174, China Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin, China Tianjin Institu
Cheng-Fen Yin	Department of Critical Care Medicine, The Third Central Hospital of Tianjin, Tianjin, 300175, China Tianjin Key Laboratory of Artificial Cell, Artificial Cell Engineering Technology Research Center of Public Health Ministry, Tianjin, China Tianjin Institu

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Abstract:

Purpose: To 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. Methods: This 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. Results: There 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. Conclusion: The 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.

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