| Zhang et al., 2013. 2121. Zhang K, Mao X, Fang Q, Jin Y, Cheng B, Xie G, et al. Impaired long-term quality of life in survivors of severe sepsis: Chinese multicenter study over 6 years. Anaesthesist. 2013;62(12):995-1002.
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• Regarding physical function assessed by the SF-36, the mean between the sepsis group and the critical controls was 79.12 ± 21.22 vs 83.18 ± 27.30, respectively. |
| • Regarding activities of daily living, 33 (78.6%) of those interviewed with severe sepsis and 26 (78.8%) of those with critical illness had no complaints about their physical condition, or had only minor complaints. Nine patients with severe sepsis and seven critical controls had a major functional impairment. At the time of the interview, 71.1% of patients who had severe sepsis and 76.7% of those with critical illness had returned to work. |
| Conclusion: Survivors of severe sepsis still had their health-related quality of life impaired, even up to six years after hospital discharge. |
| Westphal et al., 2012. 2222. Westphal GA, Vieira KD, Orzechowski R, Kaefer KM, Zaclikevis VR, Mastroeni MF. Analysis of quality of life following hospital discharge among survivors of severe sepsis and septic shock. Rev Panam Salud Publica. 2012;31(6):499-505.
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• There was impairment in the survivors compared to the control group on SF-36 domains related to Physical Function (59 ± 32 versus 91 ± 18, P < 0.001) and Physical Aspects (60 ± 45 versus 87 ± 34, P <0.02), respectively. In addition, they obtained lower scores than controls in the summary of Physical Health (62 ± 20 versus 78 ± 12; P < 0.004), respectively. |
| Conclusion: Severe sepsis may result in a significant impairment of the health-related quality of life of those surviving hospitalization, as well as compromising the likelihood of long-term survival. |
| Meurer et al., 2011. 2323. Meurer WJ, Losman ED, Smith BL, Malani PN, Younger JG. Short-term functional decline of older adults admitted for suspected sepsis. Am J Emerg Med. 2011;29(8):936-42.
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• Impaired physical function was initially more severe in patients with suspected sepsis than in controls (P <0.01 for each activity). |
| • There were no detectable differences in the degree of impaired physical function of patients with sepsis at follow-up, and interestingly, eight of 34 (23.5%) patients had an improvement in function level in one or more activities compared to their performance in the onset of the acute disease. The differences assessed at hospitalization and after 90 days were not significant in either cases or controls. |
| • Patients from households had a lower risk of functional decline than those from care facilities. |
| • None of the patients experienced an increase in residential independence after hospital discharge; and eight of the 19 survivors (42.1%) required care or had moved to a care facility 90 day after their hospitalization. |
| Conclusion: Although functional status does not consistently deteriorate in sepsis survivors, there is a considerable risk of loss of independence in the short term when evaluated in their homes. |
| Iwashyna et al., 2010. 2424. Iwashyna TJ, Ely EW, Smith DM, Langa KM. Long-term cognitive impairment and functional disability among survivors of severe sepsis. JAMA. 2010;304(16):1787-94.
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• High rates of new functional impairments were seen after sepsis: in those without impairments before sepsis, an average increase of 1.57 new impairments occurred (95% CI: 0.99 - 2.15); and for those with mild to moderate impairments before sepsis, an average increase of 1.50 new impairments was observed (95% CI 0.87 - 2.12). The decline in cognitive and physical function persisted for at least eight years. |
| Conclusion: Severe sepsis in the elderly population was associated with substantial and persistent cognitive impairment and functional disability among survivors. The magnitude of these deficits was large, resulting in the inability of these people to live independently. |
| Poulsen et al., 2009. 2525. Poulsen JB, Møller K, Kehlet H, Perner A. Long-term physical outcome in patients with septic shock. Acta Anaesthesiol Scand. 2009;53(6):724-30.
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• Scores for domains related to physical health were severely reduced in patients with septic shock compared to the equivalent control group at age and sex. |
| • Scores for the physical function domain were also reduced among patients with septic shock compared to the control group (65 vs 90, P < 0.0001). |
| • Twelve months after discharge, two-thirds of patients (47/70) reported a significant deterioration of physical function compared to pre-hospitalization status. 81% (38/47) of the patients attributed the decrease in physical fitness to loss of muscle mass. |
| • Only 43% (10 vs 23, P = 0.01) of septic shock survivors who had permanent employment prior to admission had returned to work. |
| Conclusion: Physical conditioning was substantially reduced in septic shock survivors one year after hospital discharge. |
| Hofhuis et al., 2008. 2626. Hofhuis JG, Spronk PE, van Stel HF, Schrijvers AJ, Rommes JH, Bakker J. The impact of severe sepsis on health-related quality of life: a long-term follow-up study. Anesth Analg. 2008;107(6):1957-64.
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• Six months after ICU discharge, scores for the physical function, physical aspects and general health status domains were still significantly lower than pre-admission values (all P < 0.05). |
| • In addition, scores were lower than those of the population in the domains of emotional aspects, physical function, general health status, vitality, mental health and physical aspects (all P < 0.01). |
| Conclusion: Despite they showed a gradual improvement during the six months after ICU discharge, recovery was incomplete in the physical function, physical aspects, and general health status six months after ICU discharge compared with pre-admission status. |
| Heyland et al., 2000. 88. Heyland DK, Hopman W, Coo H, Tranmer J, McColl MA. Long-term health-related quality of life in survivors of sepsis. Short Form 36: a valid and reliable measure of health-related quality of life. Crit Care Med. 2000;28(11):3599-605.
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• Sepsis survivor scores were significantly lower on the domains of physical function, physical aspects, general health status, vitality, and social aspects, as well as in the summary of overall physical health when compared to the general US population. |
| • Regarding the physical function domain, the study showed that the mean among patients with sepsis compared with the US population was 48.3 (32.7) vs 72.3 (23.3), respectively. |
| Conclusion: The long-term health-related quality of life of sepsis survivors is significantly lower than that of the general US population. The SF-36 demonstrated good reliability and validity when used to assess health-related quality of life in sepsis survivors. |
Note: Adapted from: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. Ann. Intern. Med. 151(4): 264-269