Long-term outcomes after severe shock.
Long-term outcomes after severe shock.
复制标题
严重休克后的长期结果。
DOI：
10.1097/shk.0000000000000283
复制
发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Brown,SamuelM
中科院分区：
文献类型：
--
作者：
Pratt,CristinaM;Hirshberg,EliotteL;Jones,JasonP;Kuttler,KathrynG;Lanspa,MichaelJ;Wilson,EmilyL;Hopkins,RamonaO;Brown,SamuelM
Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received≥ 1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82%(62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients’ Physical Functioning scores were below US population norms (P< 0.001), whereas mental health scores were similar to population norms. Nineteen percent of the patients had symptoms of depression, 39% had symptoms of anxiety, and 8% had symptoms of posttraumatic stress disorder. Thirty-six percent were disabled, and 17% were working full-time. Early survivors of severe shock had a high 3-year survival rate. Patients’ long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely critically ill patients have similar outcomes to general intensive care unit survivor populations.* Pulmonary and Critical Care Medicine, Intermountain Medical Center;† Center for Humanizing Critical Care, Intermountain Healthcare; and‡ Division of Pediatric Critical Care, University of Utah, Salt Lake City, Utah; § Kaiser-Permanente Southern California, Pasadena, California;∥ Homer Warner Center for Informatics Research, Intermountain Healthcare, Murray, Utah;¶ Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, Utah; and** Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah
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