Long-term quality of life in adult patients surviving purpura fulminans: an exposed-unexposed multicenter cohort study

Damien Contou (1) , Florence Canouï-Poitrine (2, 3) , Rémi Coudroy (4) , Sébastien Préau (5) , Martin Cour (6) , François Barbier (7) , Nicolas Terzi (8) , Guillaume Schnell (9) , Arnaud Galbois (10) , Lara Zafrani (11) , Benjamin Zuber (12) , Stephan Ehrmann (13) , Elodie Gelisse , Delphine Colling (14) , Matthieu Schmidt (15) , Samir Jaber (16, 17) , Alexandre Conia , Romain Sonneville (18) , Gwenhael Colin (19) , Laurent Guérin (20) , Damien Roux (21) , Sébastien Jochmans , Nancy Kentish-Barnes (22) , Etienne Audureau (3) , Richard Layese (23, 3) , Aline Alves (24) , Rachida Ouedraogo (24) , Christian Brun-Buisson (1) , Armand Mekontso Dessap (25) , Nicolas de Prost (1) , Laurent Argaud (26) , François Barbier (7) , Amélie Bazire (27) , Gaëtan Béduneau (28, 29) , Frédéric Bellec (30) , Pascal Beuret (31) , Pascal Blanc (19) , Cédric Bruel (32) , Christian Brun-Buisson (1) , Gwenhaël Colin (19) , Delphine Colling , Alexandre Conia , Rémi Coudroy , Martin Cour , Damien Contou , Fabrice Daviaud , Vincent Das , Jean Dellamonica , Nadège Demars , Stephan Ehrmann , Arnaud Galbois , Elodie Gelisse , Julien Grouille , Laurent Guérin , Emmanuel Guérot , Samir Jaber , Caroline Jannière , Sébastien Jochmans , Mathieu Jozwiak , Pierre Kalfon , Antoine Kimmoun , Alexandre Lautrette , Richard Layese , Jérémie Lemarié , Charlène Le Moal , Christophe Lenclud , Nicolas Lerolle , Olivier Leroy , Antoine Marchalot , Bruno Mégarbane (33) , Armand Mekontso Dessap , Etienne De Montmollin , Frédéric Pène , Claire Pichereau , Gaëtan Plantefève , Sébastien Préau , Gabriel Preda , Nicolas De Prost , Jean-Pierre Quenot , Sylvie Ricome , Damien Roux , Bertrand Sauneuf , Matthieu Schmidt , Guillaume Schnell , Romain Sonneville , Jean-Marc Tadié , Yacine Tandjaoui , Martial Tchir , Nicolas Terzi , Xavier Valette , Lara Zafrani , Benjamin Zuber

1 Service de réanimation médicale
2 LIC - Laboratoire d'Investigation Clinique
3 U955 Inserm - UPEC - IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil]
4 CHU de Poitiers - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
5 RID-AGE - Facteurs de Risque et Déterminants Moléculaires des Maladies liées au Vieillissement - U 1167
6 CarMeN - Cardiovasculaire, métabolisme, diabétologie et nutrition
7 IRHS - Institut de Recherche en Horticulture et Semences
8 Service de réanimation médicale [CHU Caen]
9 Service de réanimation médico-chirurgicale, Groupe Hospitalier du Havre-Hôpital Jacques Monod, Montivilliers
10 CHU Saint-Antoine [AP-HP]
11 Service de Réanimation Médicale, Hôpital Saint Louis, Paris, France
12 Hôpital Cochin [AP-HP]
13 PRPA - Pathologies Respiratoires : Protéolyse et Aérosolthérapie
14 Critical care center [CHU Lille]
15 CHU Pitié-Salpêtrière [AP-HP]
16 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
17 PhyMedExp - Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046]
18 Hôpital Bichat - Claude Bernard
19 Service de Réanimation
20 IPR - Institut de Physique de Rennes
21 Service de Réanimation Médico-Chirurgicale [Hôpital Louis Mourier]
22 Service de réanimation médicale
23 CEpiA - Clinical Epidemiology and Ageing : Geriatrie Soins Primaires et Santé Publique
24 CHU Henri Mondor [Créteil]
25 INSERM U955, équipe 13
26 HCL - Hospices Civils de Lyon
27 DMIP - Brest - Département de Médecine Interne et Pneumologie [Brest]
28 CHU Rouen
29 UNIROUEN - Université de Rouen Normandie
30 Service de réanimation et de surveillance continue [CH Mautauban]
31 Centre Hospitalier de Roanne
32 Centre hospitalier Saint-Joseph [Paris]
33 OPTeN (UMR_S 1144 / U1144) - Optimisation thérapeutique en Neuropsychopharmacologie

Long-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated. METHODS : This was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (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 (interquartile range [IQR], 35-83) months and 44 (IQR, 35-72) months, respectively, of ICU discharge (P = .23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36-53] vs 54 [IQR, 36-57]; P = .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 [IQR, 24-38] vs 52 [IQR, 42-56]; P = .001) and IADL scores (7 [IQR, 4-8] vs 8 [IQR, 7-8]; P = .021) compared with nonamputated patients. CONCLUSIONS : 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

Domaines: Sciences du Vivant [q-bio]; Cardiologie et système cardiovasculaire; Maladies émergentes; Maladies infectieuses; Pneumologie et système respiratoire; Toxicologie

Damien Contou, Florence Canouï-Poitrine, Rémi Coudroy, Sébastien Préau, Martin Cour, et al.. Long-term quality of life in adult patients surviving purpura fulminans: an exposed-unexposed multicenter cohort study. Clinical Infectious Diseases, 2019, 69 (2), p.332-340. ⟨10.1093/cid/ciy901⟩. ⟨hal-01904098⟩