Health-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial

Naomi E. Hammond; Simon R. Finfer; Qiang Li; Colman Taylor; Jeremy Cohen; Yaseen Arabi; Rinaldo Bellomo; Laurent Billot; Meg Harward; Christopher Joyce; Colin McArthur; John Myburgh; Anders Perner; Dorrilyn Rajbhandari; Andrew Rhodes; Kelly Thompson; Steve Webb; Balasubramanian Venkatesh; Keri Anne Cowdrey; Eileen Gilder; Stephanie Long; Lianne McCarthy; Shay McGuinness; Rachael Parke; Kristen Benefield; Yan Chen; Rachael McConnochie; Lynette Newby; Glenn Eastwood; Daryl Jones; Leah Peck; Helen Young; Catherine Boschert; John Edington; Jason Fletcher; Julie Smith; Dhaval Ghelani; Kiran Nand; Graham Reece; Treena Sara; Jeremy Bewley; Libby Cole; Maj Brit Nørregaard Kjær; Martin Bruun Madsen; Morten Hylander Møller; Rasmus Müller; Jonas Nielsen; Lars Quist; Hans Christian Thorsen-Meyer; Jonathan White; the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group

doi:10.1007/s00134-020-06169-1

Health-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial

Naomi E. Hammond^*, Simon R. Finfer, Qiang Li, Colman Taylor, Jeremy Cohen, Yaseen Arabi, Rinaldo Bellomo, Laurent Billot, Meg Harward, Christopher Joyce, Colin McArthur, John Myburgh, Anders Perner, Dorrilyn Rajbhandari, Andrew Rhodes, Kelly Thompson, Steve Webb, Balasubramanian Venkatesh, Keri Anne Cowdrey, Eileen GilderStephanie Long, Lianne McCarthy, Shay McGuinness, Rachael Parke, Kristen Benefield, Yan Chen, Rachael McConnochie, Lynette Newby, Glenn Eastwood, Daryl Jones, Leah Peck, Helen Young, Catherine Boschert, John Edington, Jason Fletcher, Julie Smith, Dhaval Ghelani, Kiran Nand, Graham Reece, Treena Sara, Jeremy Bewley, Libby Cole, Maj Brit Nørregaard Kjær, Martin Bruun Madsen, Morten Hylander Møller, Rasmus Müller, Jonas Nielsen, Lars Quist, Hans Christian Thorsen-Meyer, Jonathan White, the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

26 Citationer (Scopus)

Abstract

Purpose: To investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Methods: Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or ≥ 25), and severity of shock (baseline peak catecholamine doses < or ≥ 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. Results: At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = <0.0001] and pain (p = 0.0384). Amongst those treated with RRT, more patients reported increased problems with mobility (p = 0.0307) and usual activities (p = 0.0048) compared to those not treated. Bacteraemia was not associated with worse HRQoL in any domains of the EQ-5D-5L. Conclusions: Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months.

Originalsprog	Engelsk
Tidsskrift	Intensive Care Medicine
Vol/bind	46
Udgave nummer	9
Sider (fra-til)	1696-1706
Antal sider	11
ISSN	0342-4642
DOI	https://doi.org/10.1007/s00134-020-06169-1
Status	Udgivet - 2020

Adgang til dokumentet

10.1007/s00134-020-06169-1

Citationsformater

Hammond, N. E., Finfer, S. R., Li, Q., Taylor, C., Cohen, J., Arabi, Y., Bellomo, R., Billot, L., Harward, M., Joyce, C., McArthur, C., Myburgh, J., Perner, A., Rajbhandari, D., Rhodes, A., Thompson, K., Webb, S., Venkatesh, B., Cowdrey, K. A., ... the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group (2020). Health-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial. Intensive Care Medicine, 46(9), 1696-1706. https://doi.org/10.1007/s00134-020-06169-1

Health-related quality of life in survivors of septic shock : 6-month follow-up from the ADRENAL trial. / Hammond, Naomi E.; Finfer, Simon R.; Li, Qiang; Taylor, Colman; Cohen, Jeremy; Arabi, Yaseen; Bellomo, Rinaldo; Billot, Laurent; Harward, Meg; Joyce, Christopher; McArthur, Colin; Myburgh, John; Perner, Anders; Rajbhandari, Dorrilyn; Rhodes, Andrew; Thompson, Kelly; Webb, Steve; Venkatesh, Balasubramanian; Cowdrey, Keri Anne; Gilder, Eileen; Long, Stephanie; McCarthy, Lianne; McGuinness, Shay; Parke, Rachael; Benefield, Kristen; Chen, Yan; McConnochie, Rachael; Newby, Lynette; Eastwood, Glenn; Jones, Daryl; Peck, Leah; Young, Helen; Boschert, Catherine; Edington, John; Fletcher, Jason; Smith, Julie; Ghelani, Dhaval; Nand, Kiran; Reece, Graham; Sara, Treena; Bewley, Jeremy; Cole, Libby; Kjær, Maj Brit Nørregaard; Madsen, Martin Bruun; Møller, Morten Hylander; Müller, Rasmus; Nielsen, Jonas; Quist, Lars; Thorsen-Meyer, Hans Christian; White, Jonathan; the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group.

I: Intensive Care Medicine, Bind 46, Nr. 9, 2020, s. 1696-1706.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Hammond, NE, Finfer, SR, Li, Q, Taylor, C, Cohen, J, Arabi, Y, Bellomo, R, Billot, L, Harward, M, Joyce, C, McArthur, C, Myburgh, J, Perner, A, Rajbhandari, D, Rhodes, A, Thompson, K, Webb, S, Venkatesh, B, Cowdrey, KA, Gilder, E, Long, S, McCarthy, L, McGuinness, S, Parke, R, Benefield, K, Chen, Y, McConnochie, R, Newby, L, Eastwood, G, Jones, D, Peck, L, Young, H, Boschert, C, Edington, J, Fletcher, J, Smith, J, Ghelani, D, Nand, K, Reece, G, Sara, T, Bewley, J, Cole, L, Kjær, MBN, Madsen, MB, Møller, MH, Müller, R, Nielsen, J, Quist, L, Thorsen-Meyer, HC, White, J & the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group 2020, 'Health-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial', Intensive Care Medicine, bind 46, nr. 9, s. 1696-1706. https://doi.org/10.1007/s00134-020-06169-1

Hammond, Naomi E. ; Finfer, Simon R. ; Li, Qiang ; Taylor, Colman ; Cohen, Jeremy ; Arabi, Yaseen ; Bellomo, Rinaldo ; Billot, Laurent ; Harward, Meg ; Joyce, Christopher ; McArthur, Colin ; Myburgh, John ; Perner, Anders ; Rajbhandari, Dorrilyn ; Rhodes, Andrew ; Thompson, Kelly ; Webb, Steve ; Venkatesh, Balasubramanian ; Cowdrey, Keri Anne ; Gilder, Eileen ; Long, Stephanie ; McCarthy, Lianne ; McGuinness, Shay ; Parke, Rachael ; Benefield, Kristen ; Chen, Yan ; McConnochie, Rachael ; Newby, Lynette ; Eastwood, Glenn ; Jones, Daryl ; Peck, Leah ; Young, Helen ; Boschert, Catherine ; Edington, John ; Fletcher, Jason ; Smith, Julie ; Ghelani, Dhaval ; Nand, Kiran ; Reece, Graham ; Sara, Treena ; Bewley, Jeremy ; Cole, Libby ; Kjær, Maj Brit Nørregaard ; Madsen, Martin Bruun ; Møller, Morten Hylander ; Müller, Rasmus ; Nielsen, Jonas ; Quist, Lars ; Thorsen-Meyer, Hans Christian ; White, Jonathan ; the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group. / Health-related quality of life in survivors of septic shock : 6-month follow-up from the ADRENAL trial. I: Intensive Care Medicine. 2020 ; Bind 46, Nr. 9. s. 1696-1706.

@article{361f736a0a6e4fc582e4ca9f8c1c1055,

title = "Health-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial",

abstract = "Purpose: To investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Methods: Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or ≥ 25), and severity of shock (baseline peak catecholamine doses < or ≥ 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. Results: At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = <0.0001] and pain (p = 0.0384). Amongst those treated with RRT, more patients reported increased problems with mobility (p = 0.0307) and usual activities (p = 0.0048) compared to those not treated. Bacteraemia was not associated with worse HRQoL in any domains of the EQ-5D-5L. Conclusions: Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months.",

keywords = "EQ5D, Health-related quality of life, Intensive care, Sepsis, Septic shock, Steroids",

author = "Hammond, {Naomi E.} and Finfer, {Simon R.} and Qiang Li and Colman Taylor and Jeremy Cohen and Yaseen Arabi and Rinaldo Bellomo and Laurent Billot and Meg Harward and Christopher Joyce and Colin McArthur and John Myburgh and Anders Perner and Dorrilyn Rajbhandari and Andrew Rhodes and Kelly Thompson and Steve Webb and Balasubramanian Venkatesh and Cowdrey, {Keri Anne} and Eileen Gilder and Stephanie Long and Lianne McCarthy and Shay McGuinness and Rachael Parke and Kristen Benefield and Yan Chen and Rachael McConnochie and Lynette Newby and Glenn Eastwood and Daryl Jones and Leah Peck and Helen Young and Catherine Boschert and John Edington and Jason Fletcher and Julie Smith and Dhaval Ghelani and Kiran Nand and Graham Reece and Treena Sara and Jeremy Bewley and Libby Cole and Kj{\ae}r, {Maj Brit N{\o}rregaard} and Madsen, {Martin Bruun} and M{\o}ller, {Morten Hylander} and Rasmus M{\"u}ller and Jonas Nielsen and Lars Quist and Thorsen-Meyer, {Hans Christian} and Jonathan White and {the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group}",

year = "2020",

doi = "10.1007/s00134-020-06169-1",

language = "English",

volume = "46",

pages = "1696--1706",

journal = "European Journal of Intensive Care Medicine",

issn = "0935-1701",

publisher = "Springer",

number = "9",

}

TY - JOUR

T1 - Health-related quality of life in survivors of septic shock

T2 - 6-month follow-up from the ADRENAL trial

AU - Hammond, Naomi E.

AU - Finfer, Simon R.

AU - Li, Qiang

AU - Taylor, Colman

AU - Cohen, Jeremy

AU - Arabi, Yaseen

AU - Bellomo, Rinaldo

AU - Billot, Laurent

AU - Harward, Meg

AU - Joyce, Christopher

AU - McArthur, Colin

AU - Myburgh, John

AU - Perner, Anders

AU - Rajbhandari, Dorrilyn

AU - Rhodes, Andrew

AU - Thompson, Kelly

AU - Webb, Steve

AU - Venkatesh, Balasubramanian

AU - Cowdrey, Keri Anne

AU - Gilder, Eileen

AU - Long, Stephanie

AU - McCarthy, Lianne

AU - McGuinness, Shay

AU - Parke, Rachael

AU - Benefield, Kristen

AU - Chen, Yan

AU - McConnochie, Rachael

AU - Newby, Lynette

AU - Eastwood, Glenn

AU - Jones, Daryl

AU - Peck, Leah

AU - Young, Helen

AU - Boschert, Catherine

AU - Edington, John

AU - Fletcher, Jason

AU - Smith, Julie

AU - Ghelani, Dhaval

AU - Nand, Kiran

AU - Reece, Graham

AU - Sara, Treena

AU - Bewley, Jeremy

AU - Cole, Libby

AU - Kjær, Maj Brit Nørregaard

AU - Madsen, Martin Bruun

AU - Møller, Morten Hylander

AU - Müller, Rasmus

AU - Nielsen, Jonas

AU - Quist, Lars

AU - Thorsen-Meyer, Hans Christian

AU - White, Jonathan

AU - the ADRENAL Trial Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group

PY - 2020

Y1 - 2020

N2 - Purpose: To investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Methods: Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or ≥ 25), and severity of shock (baseline peak catecholamine doses < or ≥ 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. Results: At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = <0.0001] and pain (p = 0.0384). Amongst those treated with RRT, more patients reported increased problems with mobility (p = 0.0307) and usual activities (p = 0.0048) compared to those not treated. Bacteraemia was not associated with worse HRQoL in any domains of the EQ-5D-5L. Conclusions: Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months.

AB - Purpose: To investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Methods: Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or ≥ 25), and severity of shock (baseline peak catecholamine doses < or ≥ 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. Results: At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = <0.0001] and pain (p = 0.0384). Amongst those treated with RRT, more patients reported increased problems with mobility (p = 0.0307) and usual activities (p = 0.0048) compared to those not treated. Bacteraemia was not associated with worse HRQoL in any domains of the EQ-5D-5L. Conclusions: Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months.

KW - EQ5D

KW - Health-related quality of life

KW - Intensive care

KW - Sepsis

KW - Septic shock

KW - Steroids

UR - http://www.scopus.com/inward/record.url?scp=85090509268&partnerID=8YFLogxK

U2 - 10.1007/s00134-020-06169-1

DO - 10.1007/s00134-020-06169-1

M3 - Journal article

C2 - 32676679

AN - SCOPUS:85090509268

VL - 46

SP - 1696

EP - 1706

JO - European Journal of Intensive Care Medicine

JF - European Journal of Intensive Care Medicine

SN - 0935-1701

IS - 9

ER -