title: Long-term mortality and quality of life in intensive care patients treated for pneumonia and/or sepsis: Predictors of mortality and quality of life in patients with sepsis/pneumonia.
abstract: OBJECTIVE
  The purpose of this study is to evaluate long-term mortality and quality of life (QoL) of intensive care patients with pneumonia and/or sepsis 1 year after discharge and to identify potential predictors for these outcome measures.
  
  
  METHODS
  This retrospective cohort study analyzed all patients admitted to the intensive care unit (ICU) of a German university hospital with diagnosis of pneumonia and/or sepsis between 2008 and 2009. Quality of life was assessed by telephone interview or mail using the standardized EuroQol 5-dimension questionaire.
  
  
  RESULTS
  Of 1406 patients treated in the ICU within the observational period, 217 met the inclusion criteria. Whereas in-hospital mortality differed significantly between pneumonia (17%) and sepsis (46%) (P < .001), 1-year mortality was not statistically significant (51% and 65%, P = .057). A high Simplified Acute Physiology Score (SAPS) II value was associated with high in-hospital mortality but failed to predict 1-year mortality. Quality of life, measured 1 year after discharge by visual analog scale (VAS), was 50% ± 25%, which was significantly lower than in a matched control group (70% ± 20%; P < .001). A high SAPS II score on admission did not correlate with VAS but was an independent predictor of a low EuroQol 5-dimension index.
  
  
  CONCLUSIONS
  The high post-ICU mortality of patients with pneumonia and sepsis emphasizes the need to focus on long-term follow-up in ICU studies and demonstrates that even when sepsis signs are missing, critically ill patients due to pneumonia have high 1-year mortality. Simplified Acute Physiology Score II does not predict long-term mortality, but a low SAPS II on admission might be useful to identify patients with good physical status after 1 year.
  
  
  CONCLUSIONS
  Hospital mortality of patients treated for pneumonia and/or sepsis is high and increases significantly within the first year after discharge. The SAPS II predicts in-hospital mortality and the physical components of QoL but not long-term mortality.
  One-year mortality of ICU pneumonia patients is equally high as in sepsis patients. Simplified Acute Physiology Score II cannot predict long-term mortality but can predict QoL.
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Kim C
authors.initials: KC
authors.lastname: Honselmann
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Buthut
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Bjoern
authors.initials: B
authors.lastname: Heuwer
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Sevin
authors.initials: S
authors.lastname: Karadag
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Friedhelm
authors.initials: F
authors.lastname: Sayk
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Volkhardt
authors.initials: V
authors.lastname: Kurowski
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
authors.affiliation: Medical Clinic III, Pulmonology/Infectious Diseases, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Droemann
authors.affiliation: Medical Clinic II, Cardiology/Angiology/Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany; Department of Emergency Medicine, University Hospital Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23552 Luebeck, Germany. Electronic address: sebastian.wolfrum@uksh.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Wolfrum
mesh_terms: D018806:APACHE; D000368:Aged; D015331:Cohort Studies; D003422:Critical Care / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011014:Pneumonia / Q000401:mortality*; D011237:Predictive Value of Tests; D011788:Quality of Life; D012189:Retrospective Studies; D018805:Sepsis / Q000401:mortality*; D011795:Surveys and Questionnaires
keywords: SAPS II; intensive care medicine; pneumonia; quality of life; sepsis