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Journal Articles Annals of Intensive Care Year : 2021

Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study

Tomas Urbina
  • Function : Author
Florence Canoui-Poitrine
  • Function : Author
Camille Hua
  • Function : Author
Richard Layese
  • Function : Author
Aline Alves
  • Function : Author
Rachida Ouedraogo
  • Function : Author
Romain Bosc
  • Function : Author
Emilie Sbidian
  • Function : Author
Olivier Chosidow
  • Function : Author
Armand Mekontso Dessap
  • Function : Author
Nicolas de Prost
Romain Bosc
  • Function : Author
Olivier Chosidow
  • Function : Author
Nicolas de Prost
  • Function : Author
Camille Hua
  • Function : Author
Raphaël Lepeule
  • Function : Author
Alain Luciani
  • Function : Author
Lionel Nakad
  • Function : Author
Françoise Tomberli
  • Function : Author
Tomas Urbina
  • Function : Author

Abstract

Abstract Background Compared to other life-threatening infection survivors, long-term health-related quality of life (QOL) of patients surviving necrotizing soft-tissue infections (NSTI) and its determinants are little known. In this monocentric prospective cohort including NSTI survivors admitted between 2014 and 2017, QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36), the Hospital Anxiety and Depression (HAD), the activity of daily living (ADL), instrumental ADL (IADL) scales and the Impact of Event Scale-Revised (IES-R). The primary outcome measure was the SF-36 physical component summary (PCS). NSTI patients were compared according to intensive care unit (ICU) admission status. ICU survivors were matched on SAPS II with non-NSTI related septic shock survivors. Results Forty-nine NSTI survivors were phone-interviewed and included in the study. Median PCS was decreased compared to the reference population [− 0.97 (− 2.27; − 0.08) SD]. Previous cardiac disease was the only variable associated with PCS alteration [multivariate regression coefficient: − 8.86 (− 17.64; − 0.07), p = 0.048]. Of NSTI survivors, 15.2% had a HAD-D score ≥ 5 and 61.2% an IES-R score ≥ 33. ICU admission was not associated with lower PCS [35.21 (25.49–46.54) versus (vs) 41.82 (24.12–51.01), p = 0.516], but with higher IES-R score [14 (7.5–34) vs 7 (3–18), p = 0.035] and a higher proportion of HAD-D score ≥ 5 (28.6 vs 4.0%, p = 0.036). Compared to non-NSTI septic shock-matched controls, NSTI patients had similar PCS [33.81 (24.58; − 44.39) vs 44.87 (26.71; − 56.01), p = 0.706] but higher HAD-D [3.5 (1–7) vs 3 (1.5–6), p = 0.048] and IES-R scores [18 (8–35) vs 8 (3–19), p = 0.049]. Conclusions Long-term QOL in NSTI survivors is severely impaired, similarly to that of non-NSTI septic shock patients for physical compartments, but with more frequent depressive and/or post-traumatic stress disorders. Only ICU admission and previous cardiac disease were predictive of QOL impairment.

Dates and versions

hal-04298229 , version 1 (21-11-2023)

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Tomas Urbina, Florence Canoui-Poitrine, Camille Hua, Richard Layese, Aline Alves, et al.. Long-term quality of life in necrotizing soft-tissue infection survivors: a monocentric prospective cohort study. Annals of Intensive Care, 2021, 11 (1), pp.102. ⟨10.1186/s13613-021-00891-9⟩. ⟨hal-04298229⟩
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