Patrice Rosengrave, Jonathan Williman, Geoff Shaw, Anitra C Carr
{"title":"评估新西兰重症监护室收治的败血症幸存者的身体、精神和认知障碍对其健康相关生活质量的影响。","authors":"Patrice Rosengrave, Jonathan Williman, Geoff Shaw, Anitra C Carr","doi":"10.26635/6965.6638","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>To assess the impact of physical, mental and cognitive impairments on health-related quality-of-life (QoL) of individuals who have survived sepsis after admission to an Intensive Care Unit (ICU) in New Zealand.</p><p><strong>Methods: </strong>Survivors from a trial investigating vitamin C as an adjunctive therapy in patients with sepsis in Christchurch Hospital ICU were invited to enrol in a longitudinal QoL follow-up study. Patients were interviewed at hospital discharge, 30, 90 and 180 days, using validated physical and mental health assessment questionnaires (Short-Form-36, EuroQol-5-Dimension). Cognitive function was monitored and results compared with New Zealand population norms.</p><p><strong>Results: </strong>Eighteen of the 26 survivors participated in the 6-month QoL follow-up. At hospital discharge, there were significant physical and mental health issues in the participants interviewed, and although a majority of the subscales improved over the 6-month follow-up, physical function, role-physical and general health were still below population norms. Following discharge, objective parameters (mobility, self-care, usual activities) normalised within 3-6 months, while subjective measures (pain/discomfort and anxiety/depression) improved earlier and were better than population norms at 3-6 months. Cognitive dysfunction persisted over the follow-up period. Short-term (4-day) vitamin C intervention in the ICU did not affect health parameters post hospital discharge.</p><p><strong>Conclusions: </strong>Survivors of septic shock experience elevated physical, mental and cognitive issues at discharge. Most mental health issues had resolved by 6 months, but some physical and cognitive issues had not returned to population norms. Short-term vitamin C administration did not improve long-term health-related QoL; however, ongoing vitamin C supplementation may be required.</p>","PeriodicalId":48086,"journal":{"name":"NEW ZEALAND MEDICAL JOURNAL","volume":"137 1607","pages":"22-33"},"PeriodicalIF":1.2000,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Assessing the impact of physical, mental and cognitive impairments on health-related quality of life in sepsis survivors following intensive care admission in New Zealand.\",\"authors\":\"Patrice Rosengrave, Jonathan Williman, Geoff Shaw, Anitra C Carr\",\"doi\":\"10.26635/6965.6638\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>To assess the impact of physical, mental and cognitive impairments on health-related quality-of-life (QoL) of individuals who have survived sepsis after admission to an Intensive Care Unit (ICU) in New Zealand.</p><p><strong>Methods: </strong>Survivors from a trial investigating vitamin C as an adjunctive therapy in patients with sepsis in Christchurch Hospital ICU were invited to enrol in a longitudinal QoL follow-up study. Patients were interviewed at hospital discharge, 30, 90 and 180 days, using validated physical and mental health assessment questionnaires (Short-Form-36, EuroQol-5-Dimension). Cognitive function was monitored and results compared with New Zealand population norms.</p><p><strong>Results: </strong>Eighteen of the 26 survivors participated in the 6-month QoL follow-up. At hospital discharge, there were significant physical and mental health issues in the participants interviewed, and although a majority of the subscales improved over the 6-month follow-up, physical function, role-physical and general health were still below population norms. Following discharge, objective parameters (mobility, self-care, usual activities) normalised within 3-6 months, while subjective measures (pain/discomfort and anxiety/depression) improved earlier and were better than population norms at 3-6 months. Cognitive dysfunction persisted over the follow-up period. Short-term (4-day) vitamin C intervention in the ICU did not affect health parameters post hospital discharge.</p><p><strong>Conclusions: </strong>Survivors of septic shock experience elevated physical, mental and cognitive issues at discharge. Most mental health issues had resolved by 6 months, but some physical and cognitive issues had not returned to population norms. Short-term vitamin C administration did not improve long-term health-related QoL; however, ongoing vitamin C supplementation may be required.</p>\",\"PeriodicalId\":48086,\"journal\":{\"name\":\"NEW ZEALAND MEDICAL JOURNAL\",\"volume\":\"137 1607\",\"pages\":\"22-33\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-12-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"NEW ZEALAND MEDICAL JOURNAL\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.26635/6965.6638\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"NEW ZEALAND MEDICAL JOURNAL","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.26635/6965.6638","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:评估新西兰重症监护病房(ICU)中败血症幸存者的身体、精神和认知障碍对健康相关生活质量(QoL)的影响:方法:邀请基督城医院重症监护室脓毒症患者维生素 C 辅助疗法试验的幸存者参加一项纵向生活质量跟踪研究。患者在出院、住院 30 天、90 天和 180 天时接受了访谈,访谈中使用了经过验证的身体和心理健康评估问卷(Short-Form-36 和 EuroQol-5-Dimension)。对认知功能进行监测,并将结果与新西兰人口标准进行比较:结果:26 名幸存者中有 18 人参加了为期 6 个月的 QoL 随访。出院时,受访者存在严重的身心健康问题,虽然大多数分量表在 6 个月的随访中有所改善,但身体功能、角色-身体和总体健康状况仍低于人群标准。出院后,客观指标(行动能力、自理能力、日常活动)在 3-6 个月内恢复正常,而主观指标(疼痛/不适和焦虑/抑郁)则较早得到改善,并在 3-6 个月时优于人群标准。认知功能障碍在随访期间持续存在。在重症监护室进行短期(4天)维生素C干预不会影响出院后的健康参数:结论:脓毒性休克幸存者在出院时会遇到身体、精神和认知方面的更多问题。结论:脓毒性休克幸存者在出院时,身体、精神和认知方面的问题都有所增加。大多数精神健康问题在 6 个月后都得到了解决,但一些身体和认知方面的问题还没有恢复到人群标准。短期服用维生素 C 并未改善长期健康相关的 QoL;不过,可能需要持续补充维生素 C。
Assessing the impact of physical, mental and cognitive impairments on health-related quality of life in sepsis survivors following intensive care admission in New Zealand.
Aim: To assess the impact of physical, mental and cognitive impairments on health-related quality-of-life (QoL) of individuals who have survived sepsis after admission to an Intensive Care Unit (ICU) in New Zealand.
Methods: Survivors from a trial investigating vitamin C as an adjunctive therapy in patients with sepsis in Christchurch Hospital ICU were invited to enrol in a longitudinal QoL follow-up study. Patients were interviewed at hospital discharge, 30, 90 and 180 days, using validated physical and mental health assessment questionnaires (Short-Form-36, EuroQol-5-Dimension). Cognitive function was monitored and results compared with New Zealand population norms.
Results: Eighteen of the 26 survivors participated in the 6-month QoL follow-up. At hospital discharge, there were significant physical and mental health issues in the participants interviewed, and although a majority of the subscales improved over the 6-month follow-up, physical function, role-physical and general health were still below population norms. Following discharge, objective parameters (mobility, self-care, usual activities) normalised within 3-6 months, while subjective measures (pain/discomfort and anxiety/depression) improved earlier and were better than population norms at 3-6 months. Cognitive dysfunction persisted over the follow-up period. Short-term (4-day) vitamin C intervention in the ICU did not affect health parameters post hospital discharge.
Conclusions: Survivors of septic shock experience elevated physical, mental and cognitive issues at discharge. Most mental health issues had resolved by 6 months, but some physical and cognitive issues had not returned to population norms. Short-term vitamin C administration did not improve long-term health-related QoL; however, ongoing vitamin C supplementation may be required.