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

N Z Med J. 2024 Dec 13;137(1607):22-33. doi: 10.26635/6965.6638.

Abstract

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.

MeSH terms

  • Adult
  • Aged
  • Ascorbic Acid / therapeutic use
  • Cognitive Dysfunction
  • Critical Care
  • Female
  • Follow-Up Studies
  • Humans
  • Intensive Care Units
  • Longitudinal Studies
  • Male
  • Middle Aged
  • New Zealand
  • Quality of Life*
  • Sepsis* / psychology
  • Sepsis* / therapy
  • Surveys and Questionnaires
  • Survivors* / psychology

Substances

  • Ascorbic Acid