Long-term Quality of Life in Adult Patients Surviving Purpura Fulminans: An Exposed-Unexposed Multicenter Cohort Study.
SF-36
outcome
purpura fulminans
quality of life
septic shock
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
02 07 2019
02 07 2019
Historique:
received:
01
07
2018
accepted:
11
10
2018
pubmed:
20
10
2018
medline:
31
7
2020
entrez:
19
10
2018
Statut:
ppublish
Résumé
Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated. This was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36) questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale-Revised (IES-R), and the activity of daily living (ADL) and instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire. Thirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 (interquartile range [IQR], 35-83) months and 44 (IQR, 35-72) months, respectively, of ICU discharge (P = .23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36-53] vs 54 [IQR, 36-57]; P = .18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n = 12/37 [32%]) exhibited lower PCS (34 [IQR, 24-38] vs 52 [IQR, 42-56]; P = .001) and IADL scores (7 [IQR, 4-8] vs 8 [IQR, 7-8]; P = .021) compared with nonamputated patients. Long-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health. NCT03216577.
Sections du résumé
BACKGROUND
Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated.
METHODS
This was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36) questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale-Revised (IES-R), and the activity of daily living (ADL) and instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire.
RESULTS
Thirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 (interquartile range [IQR], 35-83) months and 44 (IQR, 35-72) months, respectively, of ICU discharge (P = .23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36-53] vs 54 [IQR, 36-57]; P = .18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n = 12/37 [32%]) exhibited lower PCS (34 [IQR, 24-38] vs 52 [IQR, 42-56]; P = .001) and IADL scores (7 [IQR, 4-8] vs 8 [IQR, 7-8]; P = .021) compared with nonamputated patients.
CONCLUSIONS
Long-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health.
CLINICAL TRIALS REGISTRATION
NCT03216577.
Identifiants
pubmed: 30335142
pii: 5134208
doi: 10.1093/cid/ciy901
doi:
Banques de données
ClinicalTrials.gov
['NCT03216577']
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
332-340Investigateurs
Laurent Argaud
(L)
François Barbier
(F)
Amélie Bazire
(A)
Gaëtan Béduneau
(G)
Frédéric Bellec
(F)
Pascal Beuret
(P)
Pascal Blanc
(P)
Cédric Bruel
(C)
Christian Brun-Buisson
(C)
Gwenhaël Colin
(G)
Delphine Colling
(D)
Alexandre Conia
(A)
Rémi Coudroy
(R)
Martin Cour
(M)
Damien Contou
(D)
Fabrice Daviaud
(F)
Vincent Das
(V)
Jean Dellamonica
(J)
Nadège Demars
(N)
Stephan Ehrmann
(S)
Arnaud Galbois
(A)
Elodie Gelisse
(E)
Julien Grouille
(J)
Laurent Guérin
(L)
Emmanuel Guérot
(E)
Samir Jaber
(S)
Caroline Jannière
(C)
Sébastien Jochmans
(S)
Mathieu Jozwiak
(M)
Pierre Kalfon
(P)
Antoine Kimmoun
(A)
Alexandre Lautrette
(A)
Richard Layese
(R)
Jérémie Lemarié
(J)
Charlène Le Moal
(C)
Christophe Lenclud
(C)
Nicolas Lerolle
(N)
Olivier Leroy
(O)
Antoine Marchalot
(A)
Bruno Mégarbane
(B)
Armand Mekontso Dessap
(A)
Etienne de Montmollin
(E)
Frédéric Pène
(F)
Claire Pichereau
(C)
Gaëtan Plantefève
(G)
Sébastien Préau
(S)
Gabriel Preda
(G)
Nicolas de Prost
(N)
Jean-Pierre Quenot
(JP)
Sylvie Ricome
(S)
Damien Roux
(D)
Bertrand Sauneuf
(B)
Matthieu Schmidt
(M)
Guillaume Schnell
(G)
Romain Sonneville
(R)
Jean-Marc Tadié
(JM)
Yacine Tandjaoui
(Y)
Martial Tchir
(M)
Nicolas Terzi
(N)
Xavier Valette
(X)
Lara Zafrani
(L)
Benjamin Zuber
(B)
Informations de copyright
© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.