Mortality and quality of life in the five years after severe sepsis

Brian H Cuthbertson, Andrew Elders, Sally Hall, Jane Taylor, Graeme Maclennan, Fiona Mackirdy, Simon J Mackenzie, the Scottish Critical Care Trials Group and the Scottish Intensive Care Society Audit Group

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Abstract

INTRODUCTION: Severe sepsis is associated with high levels of morbidity and mortality, placing a high burden on healthcare resources. We aimed to study outcomes in the five years after severe sepsis.

METHODS: This was a cohort study using data from a prospective audit in 26 adult ICUs in Scotland. Mortality was measured using clinical databases and quality of life using Short Form 36 (SF-36) at 3.5 and 5 years after severe sepsis.

RESULTS: A total of 439 patients were recruited with a 58% mortality at 3.5 years and 61% mortality at 5 years. A total of 85 and 67 patients responded at 3.5 and 5 years follow-up, respectively. SF-36 physical component score (PCS) was low compared to population controls at 3.5 years (mean 41.8 (SD 11.8)) and at 5 years (mean 44.8 (SD 12.7)). SF-36 mental component score (MCS) was slightly lower than population controls at 3.5 years (mean 47.7 (SD 14.6)) and at 5 years after severe sepsis (mean 48.8 (SD 12.6)). The majority of patients were satisfied with their current quality of life (QOL) (80%) and all patients would be willing to be treated in an ICU again if they become critically ill despite many having unpleasant memories (19%) and recall (29%) of ICU events.

CONCLUSIONS: Patients with severe sepsis have a high ongoing mortality after severe sepsis. They also have a significantly lower physical QOL compared to population norms but mental QOL scores were only slightly below population norms up to five years after severe sepsis. All survivors would be willing to be treated in an ICU again if critically ill. Mortality and QOL outcomes were broadly similar to other critically ill cohorts throughout the five years of follow-up.

Original languageEnglish
Article numberR70
JournalCritical Care
Volume17
Issue number2
DOIs
Publication statusPublished - 16 Apr 2013

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Sepsis
Quality of Life
Mortality
Critical Illness
Population Control
Scotland
Population
Survivors
Cohort Studies
Outcome Assessment (Health Care)
Databases
Morbidity
Delivery of Health Care

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Cuthbertson, B. H., Elders, A., Hall, S., Taylor, J., Maclennan, G., Mackirdy, F., ... the Scottish Critical Care Trials Group and the Scottish Intensive Care Society Audit Group (2013). Mortality and quality of life in the five years after severe sepsis. Critical Care, 17(2), [R70]. https://doi.org/10.1186/cc12616

Mortality and quality of life in the five years after severe sepsis. / Cuthbertson, Brian H; Elders, Andrew; Hall, Sally; Taylor, Jane; Maclennan, Graeme; Mackirdy, Fiona; Mackenzie, Simon J; the Scottish Critical Care Trials Group and the Scottish Intensive Care Society Audit Group.

In: Critical Care, Vol. 17, No. 2, R70, 16.04.2013.

Research output: Contribution to journalArticle

Cuthbertson, BH, Elders, A, Hall, S, Taylor, J, Maclennan, G, Mackirdy, F, Mackenzie, SJ & the Scottish Critical Care Trials Group and the Scottish Intensive Care Society Audit Group 2013, 'Mortality and quality of life in the five years after severe sepsis', Critical Care, vol. 17, no. 2, R70. https://doi.org/10.1186/cc12616
Cuthbertson BH, Elders A, Hall S, Taylor J, Maclennan G, Mackirdy F et al. Mortality and quality of life in the five years after severe sepsis. Critical Care. 2013 Apr 16;17(2). R70. https://doi.org/10.1186/cc12616
Cuthbertson, Brian H ; Elders, Andrew ; Hall, Sally ; Taylor, Jane ; Maclennan, Graeme ; Mackirdy, Fiona ; Mackenzie, Simon J ; the Scottish Critical Care Trials Group and the Scottish Intensive Care Society Audit Group. / Mortality and quality of life in the five years after severe sepsis. In: Critical Care. 2013 ; Vol. 17, No. 2.
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AU - Taylor, Jane

AU - Maclennan, Graeme

AU - Mackirdy, Fiona

AU - Mackenzie, Simon J

AU - the Scottish Critical Care Trials Group and the Scottish Intensive Care Society Audit Group

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N2 - INTRODUCTION: Severe sepsis is associated with high levels of morbidity and mortality, placing a high burden on healthcare resources. We aimed to study outcomes in the five years after severe sepsis.METHODS: This was a cohort study using data from a prospective audit in 26 adult ICUs in Scotland. Mortality was measured using clinical databases and quality of life using Short Form 36 (SF-36) at 3.5 and 5 years after severe sepsis.RESULTS: A total of 439 patients were recruited with a 58% mortality at 3.5 years and 61% mortality at 5 years. A total of 85 and 67 patients responded at 3.5 and 5 years follow-up, respectively. SF-36 physical component score (PCS) was low compared to population controls at 3.5 years (mean 41.8 (SD 11.8)) and at 5 years (mean 44.8 (SD 12.7)). SF-36 mental component score (MCS) was slightly lower than population controls at 3.5 years (mean 47.7 (SD 14.6)) and at 5 years after severe sepsis (mean 48.8 (SD 12.6)). The majority of patients were satisfied with their current quality of life (QOL) (80%) and all patients would be willing to be treated in an ICU again if they become critically ill despite many having unpleasant memories (19%) and recall (29%) of ICU events.CONCLUSIONS: Patients with severe sepsis have a high ongoing mortality after severe sepsis. They also have a significantly lower physical QOL compared to population norms but mental QOL scores were only slightly below population norms up to five years after severe sepsis. All survivors would be willing to be treated in an ICU again if critically ill. Mortality and QOL outcomes were broadly similar to other critically ill cohorts throughout the five years of follow-up.

AB - INTRODUCTION: Severe sepsis is associated with high levels of morbidity and mortality, placing a high burden on healthcare resources. We aimed to study outcomes in the five years after severe sepsis.METHODS: This was a cohort study using data from a prospective audit in 26 adult ICUs in Scotland. Mortality was measured using clinical databases and quality of life using Short Form 36 (SF-36) at 3.5 and 5 years after severe sepsis.RESULTS: A total of 439 patients were recruited with a 58% mortality at 3.5 years and 61% mortality at 5 years. A total of 85 and 67 patients responded at 3.5 and 5 years follow-up, respectively. SF-36 physical component score (PCS) was low compared to population controls at 3.5 years (mean 41.8 (SD 11.8)) and at 5 years (mean 44.8 (SD 12.7)). SF-36 mental component score (MCS) was slightly lower than population controls at 3.5 years (mean 47.7 (SD 14.6)) and at 5 years after severe sepsis (mean 48.8 (SD 12.6)). The majority of patients were satisfied with their current quality of life (QOL) (80%) and all patients would be willing to be treated in an ICU again if they become critically ill despite many having unpleasant memories (19%) and recall (29%) of ICU events.CONCLUSIONS: Patients with severe sepsis have a high ongoing mortality after severe sepsis. They also have a significantly lower physical QOL compared to population norms but mental QOL scores were only slightly below population norms up to five years after severe sepsis. All survivors would be willing to be treated in an ICU again if critically ill. Mortality and QOL outcomes were broadly similar to other critically ill cohorts throughout the five years of follow-up.

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