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Παρασκευή 18 Ιανουαρίου 2019

The Development of Chronic Critical Illness Determines Physical Function, Quality of Life, and Long-Term Survival Among Early Survivors of Sepsis in Surgical ICUs

Objectives: This study sought to examine mortality, health-related quality of life, and physical function among sepsis survivors who developed chronic critical illness. Design: Single-institution, prospective, longitudinal, observational cohort study assessing 12-month outcomes. Setting: Two surgical/trauma ICUs at an academic tertiary medical and level 1 trauma center. Patients: Adult critically ill patients that survived 14 days or longer after sepsis onset. Interventions: None. Measurements and Main Results: Baseline patient characteristics and function, sepsis severity, and clinical outcomes of the index hospitalization were collected. Follow-up physical function (short physical performance battery; Zubrod; hand grip strength) and health-related quality of life (EuroQol-5D-3L, Short Form-36) were measured at 3, 6, and 12 months. Hospital-free days and mortality were determined at 12 months. We compared differences in long-term outcomes between subjects who developed chronic critical illness (≥ 14 ICU days with persistent organ dysfunction) versus those with rapid recovery. The cohort consisted of 173 sepsis patients; 63 (36%) developed chronic critical illness and 110 (64%) exhibited rapid recovery. Baseline physical function and health-related quality of life did not differ between groups. Those who developed chronic critical illness had significantly fewer hospital-free days (196 ± 148 vs 321 ± 65; p

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