Background: Long-term Health-related Quality of Life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated.
Methods: A French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 ICUs for a PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, SAPS II and gender with septic shock survivors (unexposed group). HR-QOL was assessed during a phone-interview using the SF-36 questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale-Revised (IES-R) and the Activity of Daily Living (ADL) and Instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire.
Results: Thirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 [35-83] and 44 [35-72] months of ICU discharge, respectively (p=0.23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median [quartile1-quartile3]=47 [36-53] vs. 54 [36-57]; p=0.18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n=12/37, 32%) exhibited lower PCS (34 [24-38] vs. 52 [42-56]; p=0.001) and IADL scores (7 [4-8] vs. 8 [7-8]; p=0.021) as compared to non-amputated patients.
Conclusion: Long-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health.
Clinical Trials: NCT03216577.