title: Quality of life one year post-Shiga toxin-producing Escherichia coli O104 infection--a prospective cohort study.
abstract: BACKGROUND
  In 2011, a major outbreak of hemolytic-uremic syndrome (HUS) and bloody diarrhea related to infections from Shiga toxin-producing Escherichia coli O104 (STEC) occurred in Germany. While previous research has focused on the medical components of this disease, we aimed to investigate the course of health-related quality of life (HrQoL) over 12 months including somatic and psychosocial risk factors. Furthermore, the influence of chronic fatigue (CF) on HrQoL was examined.
  
  
  METHODS
  A prospective cohort study with n = 389 patients completing self-report scales at baseline, after 6 months (participation rate: 79%) and after 12 months (participation rate: 77%). The courses of physical and mental HrQoL over the 12 month period were calculated by employing general linear mixed models.
  
  
  RESULTS
  While the physical component score of HrQoL reached a score comparable to the general population, the mental component score remained below average 12 months after STEC infection. Female gender, prior psychiatric disorder, and prior traumatic events were risk factors for a worse HrQoL course after 12 months, while social support was identified to be protective. CF was associated with low HrQoL. In addition, the somatic symptom burden remained persistently high.
  
  
  CONCLUSIONS
  Our results show high somatic and psychosocial burden in patients 12 months after STEC infection. We recommend considering the risk factors and protective factors of poor HrQoL early in the treatment of STEC or similar diseases. Patients who are suffering from persisting somatic symptoms, CF, and impaired HrQoL may require specific aftercare.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Centre Hamburg-Eppendorf, and Schön Klinik Hamburg Eilbek, Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Riegel
authors.forename: W
authors.initials: W
authors.lastname: Broicher
authors.forename: K
authors.initials: K
authors.lastname: Wegscheider
authors.forename: V
authors.initials: V
authors.lastname: Andresen
authors.forename: E
authors.initials: E
authors.lastname: Brähler
authors.forename: A W
authors.initials: AW
authors.lastname: Lohse
authors.forename: B
authors.initials: B
authors.lastname: Löwe
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004196:Disease Outbreaks; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000523:psychology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006463:Hemolytic-Uremic Syndrome / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D054323:Shiga-Toxigenic Escherichia coli
keywords: Shiga toxigenic Escherichia coli; chronic fatigue; health-related quality of life; hemolytic-uremic syndrome