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- Title
Long-term Quality of Life in Adult Patients Surviving Purpura Fulminans: An Exposed-Unexposed Multicenter Cohort Study.
- Authors
Contou, Damien; Canoui-Poitrine, Florence; Coudroy, Rémi; Préau, Sébastien; Cour, Martin; Barbier, François; Terzi, Nicolas; Schnell, Guillaume; Galbois, Arnaud; Zafrani, Lara; Zuber, Benjamin; Ehrmann, Stephan; Gelisse, Elodie; Colling, Delphine; Schmidt, Matthieu; Jaber, Samir; Conia, Alexandre; Sonneville, Romain; Colin, Gwenhaël; Guérin, Laurent
- Abstract
Background Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated. Methods This was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36) questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale–Revised (IES-R), and the activity of daily living (ADL) and instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire. Results Thirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 (interquartile range [IQR], 35–83) months and 44 (IQR, 35–72) months, respectively, of ICU discharge (P =.23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36–53] vs 54 [IQR, 36–57]; P =.18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n = 12/37 [32%]) exhibited lower PCS (34 [IQR, 24–38] vs 52 [IQR, 42–56]; P =.001) and IADL scores (7 [IQR, 4–8] vs 8 [IQR, 7–8]; P =.021) compared with nonamputated patients. Conclusions Long-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health. Clinical Trials Registration NCT03216577.
- Subjects
ANXIETY diagnosis; DIAGNOSIS of mental depression; AGE distribution; AMPUTATION; EXTREMITIES (Anatomy); HEALTH surveys; HOSPITAL admission &; discharge; INTENSIVE care units; INTERVIEWING; LONGITUDINAL method; MEDICAL cooperation; MENTAL health; PATIENTS; QUALITY of life; QUESTIONNAIRES; RESEARCH; SEPTIC shock; SEX distribution; TREATMENT effectiveness; SCHOENLEIN-Henoch purpura; ADULTS
- Publication
Clinical Infectious Diseases, 2019, Vol 69, Issue 2, p332
- ISSN
1058-4838
- Publication type
Article
- DOI
10.1093/cid/ciy901