Long-term Quality of Life in Adult Patients Surviving Purpura Fulminans: An Exposed-Unexposed Multicenter Cohort Study

Medientyp: E-Artikel
Titel: Long-term Quality of Life in Adult Patients Surviving Purpura Fulminans: An Exposed-Unexposed Multicenter Cohort Study
Beteiligte: Contou, Damien; Canoui-Poitrine, Florence; Coudroy, Rémi; Préau, Sébastien; Cour, Martin; Barbier, François; Terzi, Nicolas; Schnell, Guillaume; Galbois, Arnaud; Zafrani, Lara; Zuber, Benjamin; Ehrmann, Stephan; Gelisse, Elodie; Colling, Delphine; Schmidt, Matthieu; Jaber, Samir; Conia, Alexandre; Sonneville, Romain; Colin, Gwenhaël; Guérin, Laurent; Roux, Damien; Jochmans, Sébastien; Kentish-Barnes, Nancy; Audureau, Etienne; [...]
Erschienen: Oxford University Press (OUP), 2019
Erschienen in: Clinical Infectious Diseases
Sprache: Englisch
DOI: 10.1093/cid/ciy901
ISSN: 1058-4838; 1537-6591
Schlagwörter: Infectious Diseases ; Microbiology (medical)
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Beschreibung: <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec> <jats:sec> <jats:title>Clinical Trials Registration</jats:title> <jats:p>NCT03216577.</jats:p> </jats:sec>
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