Quality of life in ICU survivors with severe sepsis who received activated protein C

Appropriate treatment of severe sepsis with activated protein C (rhAPC) has been associated with an absolute reduction in mortality of 6.1% [1]. The aim of this study was to followup patients who received rhAPC and to evaluate their quality of life postdischarge from the intensive care unit (ICU).

Method

Twenty-three patients in our unit were recruited into the ENHANCE study and received rhAPC. The 28 and 90 day mortality was calculated and quality of life was assessed at 90 days using the Short Form-36 (SF-36) [2]. Psychological distress and depression was measured at the same time using the Hospital Anxiety and Depression score (HAD) [3].

Results

Twenty-three subjects had at least three or more acute organ dysfunction associated with severe sepsis, with a range of APACHE II scores of 8–33. The median length of stay in ICU for survivors was 16.4 days, and hospital stay post-ICU was 19.5 days. The 28 and 90 day all-cause mortality was 21.7% (five patients) and 26.1% (six patients), respectively. Eight of the 17 survivors completed the SF-36 (Table 1) and HAD forms. HAD scores indicated heightened anxiety in two patients and none were clinically depressed.

Table 1 SF-36 scores for patients who received rhAPC, published figures for a general ICU population [4] and those of the UK population [2]

Conclusion

Mortality is similar to that already published [1]. Encouraging, the quality of life for these patients is comparable at 90 days with a general ICU population. A limitation is the number of patients.