Quality of life of sepsis survivors: evaluation with a specific critical care questionnaire

Introduction

Health-related quality of life (HR-QOL) is a relevant measurement of intensive care unit (ICU) outcome. This study aims to evaluate the HR-QOL in survivors of severe sepsis and septic shock (sepsis group) compared with survivors without sepsis (control group), using a specific questionnaire (QOL-SP), developed by Fernandez.

Methods

Six months after ICU discharge, survivors went to a follow-up consultation and the QOL-SP was applied. The QOL-SP comprises 15 items grouped in three subscales, which evaluate Basic Physiologic Activities (BPA), Normal Daily Activities (NDA) and Emotional State (ES), and enables the calculation of a global index (QOL-SP Index). Patients from the sepsis group were compared with those from the control group concerning background variables (age, sex, gender, previous health state), ICU variables (reason for admission, APACHE II score and length of ICU stay) and QOL-SP variables. Patients younger than 18 years old and those with an ICU stay ≤ 1 day were excluded. Patients exhibiting nonsevere sepsis at or after ICU admission, and those with severe sepsis/septic shock after ICU admission were also excluded.

Results

Between March 1997 and March 2001, a total of 1285 patients were admitted to the ICU, from which 697 were included in the study. From these, 305(44%) were admitted for severe sepsis/septic shock. Mortality in the sepsis group was 34% and in the control group was 26%. One hundred and four patients from the sepsis group and 133 patients from the control group completed the QOL-SP questionnaire. There were no differences in age and previous health state between both groups. Patients from the sepsis group exhibit a significantly higher APACHE II score and a significantly higher ICU stay. Sepsis survivors reported significantly less problems in the BPA and NDA subscales; furthermore, although not statistically significant, they exhibit a better QOL-SP index than the control group (Table 1).

Table 1

Conclusion

At 6 months after ICU discharge, when evaluated with a specific critical care questionnaire, survivors of severe sepsis/septic shock exhibited a similar, if not a better, HR-QOL than ICU survivors without sepsis.