Health-Related Quality of Life of Adult Sepsis Survivors Following Critical Illness: A Systematic Review.

Abstract

Objective: As survival following sepsis improves, there is increased attention on the health-related quality of life (HRQoL) of survivors following critical illness. The aim of this study is to systematically review the literature on the HRQoL of adult sepsis survivors following critical illness.

Data sources: OVID MEDLINE, Embase, and CINAHL were searched using a combination of MeSH subject headings and keywords.

Study selection: English-language studies published between January 2009 and June 2024, which investigated the HRQoL of adult sepsis survivors at 90 days or more following critical illness.

Data extraction: Extracted data from included studies comprised HRQoL findings, the instruments administered, and representation of adult survivors following critical illness. Risk-of-bias quality assessment was assessed using the Cochrane Risk of Bias In Non-Randomised Studies - of Exposure tool. Selection of studies, data extraction, and quality assessment were conducted independently by two reviewers.

Data synthesis: Thrity-three eligible studies were yielded from 25,611 records, with the sample size among included studies ranging from 55 to 2,151 participants. Included studies were mostly conducted in Europe. The EuroQol 5-dimension three-level instrument was most commonly administered (19 [58%] studies). Our review found that adult sepsis survivors following critical illness have lower HRQoL than population norms, regardless of follow-up timepoint. No significant difference was found in the HRQoL of adult survivors following critical illness with or without sepsis. High risk of bias in included studies was mostly due to missing data and confounding.

Conclusions: As survival following critical illness improves, future research on improving long-term HRQoL following sepsis is crucial.