Quality of Life and 1-Year Survival in Patients With Early Septic Shock: Long-Term Follow-Up of the Australasian Resuscitation in Sepsis Evaluation Trial.

Abstract

OBJECTIVES:

To examine long-term survival and quality of life of patients with early septic shock.

DESIGN:

Prospective, randomized, parallel-group trial.

SETTING:

Fifty-one hospitals in Australia, New Zealand, Finland, Hong Kong, and the Republic of Ireland.

PATIENTS:

One-thousand five-hundred ninety-one patients who presented to the emergency department with early septic shock between October 2008 and April 2014, and were enrolled in the Australasian Resuscitation in Sepsis Evaluation trial.

INTERVENTIONS:

Early goal-directed therapy versus usual care.

MEASUREMENTS AND MAIN RESULTS:

Long-term survival was measured up to 12 months postrandomization. Health-related quality of life was measured using the EuroQoL-5D-3L, Short Form 36 and Assessment of Quality of Life 4D at baseline, and at 6 and 12 months following randomization. Mortality data were available for 1,548 patients (97.3%) and 1,515 patients (95.2%) at 6 and 12 months, respectively. Health-related quality of life data were available for 85.1% of survivors at 12 months. There were no significant differences in mortality between groups at either 6 months (early goal-directed therapy 21.8% vs usual care 22.6%; p = 0.70) or 12 months (early goal-directed therapy 26.4% vs usual care 27.9%; p = 0.50). There were no group differences in health-related quality of life at either 6 or 12 months (EuroQoL-5D-3L utility scores at 12 mo early goal-directed therapy 0.65 ± 0.33 vs usual care 0.64 ± 0.34; p = 0.50), with the health-related quality of life of both groups being significantly lower than population norms.

CONCLUSIONS:

In patients presenting to the emergency department with early septic shock, early goal-directed therapy compared with usual care did not reduce mortality nor improve health-related quality of life at either 6 or 12 months.

• Authors: Alisa M Higgins, Sandra L Peake, Rinaldo Bellomo, D Jamie Cooper, Anthony Delaney, Anthony H Harris, Belinda D Howe, Alistair D Nichol, Steve A Webb, Patricia J Williams, Australasian Resuscitation in Sepsis Evaluation (ARISE) Investigators and the ANZICS Clinical Trials Group
• Journal: Critical care medicine (Crit Care Med) Vol. 47 Issue 6 Pg. 765-773 (06 2019) ISSN: 1530-0293 [Electronic] United States
• PMID: 30985391 (Publication Type: Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Australia (epidemiology)
• Early Goal-Directed Therapy
• Female
• Finland (epidemiology)
• Follow-Up Studies
• Hong Kong (epidemiology)
• Humans
• Ireland (epidemiology)
• Male
• Middle Aged
• New Zealand (epidemiology)
• Prospective Studies
• Quality of Life
• Resuscitation (methods)
• Shock, Septic (mortality, therapy)
• Survival Rate
• Time Factors