Long-term outcome and quality of life of patients treated in surgical intensive care: a comparison between sepsis and trauma

Objective

To determine long-term survival and quality of life of patients treated in the SICU due to sepsis or trauma.

Design

An observational study in an 11-bed closed SICU at a 860-bed general hospital during a 1-year period (January 2003-December 2003).

Patients and methods

Patients were divided into two groups according to admission diagnoses: group 1, sepsis or group 2, trauma (polytrauma, multiple trauma, head injury, spinal injury). Quality of life was assessed after 2 years following intensive care admission using the EuroQol 5D (EQ-5D) questionnaire.

Results

A total of 164 patients (66 trauma patients and 98 patients with sepsis) were included in the study. Trauma patients were younger compared with patients with sepsis (53 ± 21 years vs 64 ± 13 years, P < 0.001). There was no statistical significant difference between both groups in APACHE II score and length of stay in the SICU. Trauma patients were hospitalized longer in the general ward (35 ± 44 days vs 17 ± 24 days, P < 001).

SICU survival, hospital survival and 2-year survival were lower in the sepsis group compared with the trauma group (60% vs 74%, 42% vs 62% and 33% vs 57%, respectively, P < 0.05). Long-term mortality of the sepsis and trauma groups were higher compared with the age-matched healthy population (nine times vs six times, respectively).

There was no statistically significant difference in quality of life in all five dimensions of EQ-5D between groups: almost 70% of patients had pains, 62% mobility problems, 50% signs of depression.

Conclusion

Patients with sepsis treated in the SICU have higher short-term and long-term mortality compared with trauma patients. However, quality of life is reduced to the same level in both groups.