title: Long-Term Quality of Life Among Survivors of Severe Sepsis: Analyses of Two International Trials.
abstract: OBJECTIVE
  To describe the quality of life among sepsis survivors.
  
  
  METHODS
  Secondary analyses of two international, randomized clinical trials (A Controlled Comparison of Eritoran and placebo in patients with Severe Sepsis [derivation cohort] and PROWESS-SHOCK [validation cohort]).
  
  
  METHODS
  ICUs in North and South America, Europe, Africa, Asia, and Australia.
  
  
  METHODS
  Adults with severe sepsis. We analyzed only patients who were functional and living at home without help before sepsis hospitalization (n = 1,143 and 987 from A Controlled Comparison of Eritoran and placebo in patients with Severe Sepsis and PROWESS-SHOCK, respectively).
  
  
  METHODS
  None.
  
  
  RESULTS
  In A Controlled Comparison of Eritoran and placebo in patients with Severe Sepsis and PROWESS-SHOCK, the average age of patients living at home independently was 63 and 61 years; 400 (34.9%) and 298 (30.2%) died by 6 months. In A Controlled Comparison of Eritoran and placebo in patients with Severe Sepsis, 580 patients had a quality of life measured using EQ-5D at 6 months. Of these, 41.6% could not live independently (22.7% were home but required help, 5.1% were in nursing home or rehabilitation facilities, and 5.3% were in acute care hospitals). Poor quality of life at 6 months, as evidenced by problems in mobility, usual activities, and self-care domains were reported in 37.4%, 43.7%, and 20.5%, respectively, and the high incidence of poor quality of life was also seen in patients in PROWESS-SHOCK. Over 45% of patients with mobility and self-care problems at 6 months in A Controlled Comparison of Eritoran and placebo in patients with Severe Sepsis died or reported persistent problems at 1 year.
  
  
  CONCLUSIONS
  Among individuals enrolled in a clinical trial who lived independently prior to severe sepsis, one third had died and of those who survived, a further one third had not returned to independent living by 6 months. Both mortality and quality of life should be considered when designing new interventions and considering endpoints for sepsis trials.
authors.affiliation: 1The Clinical Research, Investigation, and Systems Modeling of Acute Illness (CRISMA) Center, Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA. 2Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA. 3Research and Development, Quality Improvement Department, Gateway Health, Pittsburgh, PA. 4Adult Critical Care, St. George's University Hospitals, NHS Foundation Trust, London, United Kingdom. 5The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia. 6Infectious Disease Division, Alpert Medical School of Brown University, Pawtucket, RI. 7Pulmonary and Critical Care Division, Massachusetts General Hospital, Boston, MA. 8Evandro Chagas National Institute of Infectious Diseases, Fundação Oswaldo Cruz (FIOCRUZ), Rio de Janeiro, Brazil. 9Beverly Hospital, Lahey Health System, Beverly, MA. 10Department of Anesthesia and Intensive Care Medicine, University Sapienza of Rome, Policlino Umberto I Hospital, Rome, Italy.
authors.forename: Sachin
authors.initials: S
authors.lastname: Yende
authors.forename: Shamly
authors.initials: S
authors.lastname: Austin
authors.forename: Andrew
authors.initials: A
authors.lastname: Rhodes
authors.forename: Simon
authors.initials: S
authors.lastname: Finfer
authors.forename: Steven
authors.initials: S
authors.lastname: Opal
authors.forename: Taylor
authors.initials: T
authors.lastname: Thompson
authors.forename: Fernando A
authors.initials: FA
authors.lastname: Bozza
authors.forename: Steven P
authors.initials: SP
authors.lastname: LaRosa
authors.forename: V Marco
authors.initials: VM
authors.lastname: Ranieri
authors.forename: Derek C
authors.initials: DC
authors.lastname: Angus
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015897:Comorbidity; D004187:Disaccharides / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D011788:Quality of Life; D018805:Sepsis / Q000188:drug therapy / Q000401:mortality*; D012720:Severity of Illness Index; D013403:Sugar Phosphates / Q000627:therapeutic use; D017741:Survivors / Q000706:statistics & numerical data*
chemical_list: D004187:Disaccharides; D013403:Sugar Phosphates; C512420:eritoran