Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/23871
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dc.contributor.authorHammond, Naomi E-
dc.contributor.authorFinfer, Simon R-
dc.contributor.authorLi, Qiang-
dc.contributor.authorTaylor, Colman-
dc.contributor.authorCohen, Jeremy-
dc.contributor.authorArabi, Yaseen-
dc.contributor.authorBellomo, Rinaldo-
dc.contributor.authorBillot, Laurent-
dc.contributor.authorHarward, Meg-
dc.contributor.authorJoyce, Christopher-
dc.contributor.authorMcArthur, Colin-
dc.contributor.authorMyburgh, John-
dc.contributor.authorPerner, Anders-
dc.contributor.authorRajbhandari, Dorrilyn-
dc.contributor.authorRhodes, Andrew-
dc.contributor.authorThompson, Kelly-
dc.contributor.authorWebb, Steve-
dc.contributor.authorVenkatesh, Balasubramanian-
dc.date2020-07-16-
dc.date.accessioned2020-07-27T05:09:34Z-
dc.date.available2020-07-27T05:09:34Z-
dc.date.issued2020-09-
dc.identifier.citationIntensive Care Medicine 2020; 46(9): 1696-1706en
dc.identifier.urihttps://ahro.austin.org.au/austinjspui/handle/1/23871-
dc.description.abstractTo investigate the impact of hydrocortisone treatment and illness severity on health-related quality of life (HRQoL) at 6 months in septic shock survivors from the ADRENAL trial. Using the EuroQol questionnaire (EQ-5D-5L) at 6 months after randomization we assessed HRQoL in patient subgroups defined by hydrocortisone or placebo treatment, gender, illness severity (APACHE II < or ≥ 25), and severity of shock (baseline peak catecholamine doses < or ≥ 15 mcg/min). Additionally, in subgroups defined by post-randomisation variables; time to shock reversal (days), treatment with renal replacement therapy (RRT), and presence of bacteremia. At 6 months, there were 2521 survivors. Of these 2151 patients (85.3%-1080 hydrocortisone and 1071 placebo) completed 6-month follow-up. Overall, at 6 months the mean EQ-5D-5L visual analogue scale (VAS) was 70.8, mean utility score 59.4. Between 15% and 30% of patients reported moderate to severe problems in any given HRQoL domain. There were no differences in any EQ-5D-5L domain in patients who received hydrocortisone vs. placebo, nor in the mean VAS (p = 0.6161), or mean utility score (p = 0.7611). In all patients combined, males experienced lower pain levels compared to females [p = 0.0002). Neither higher severity of illness or shock impacted reported HRQoL. In post-randomisation subgroups, longer time to shock reversal was associated with increased problems with mobility (p = < 0.0001]; self-care (p = 0.0.0142), usual activities (p = <0.0001] and pain (p = 0.0384). Amongst those treated with RRT, more patients reported increased problems with mobility (p = 0.0307) and usual activities (p = 0.0048) compared to those not treated. Bacteraemia was not associated with worse HRQoL in any domains of the EQ-5D-5L. Approximately one fifth of septic shock survivors report moderate to extreme problems in HRQoL domains at 6 months. Hydrocortisone treatment for septic shock was not associated with improved HRQoL at 6 months. Female gender was associated with worse pain at 6 months.en
dc.language.isoeng
dc.subjectEQ5Den
dc.subjectHealth-related quality of lifeen
dc.subjectIntensive careen
dc.subjectSepsisen
dc.subjectSeptic shocken
dc.subjectSteroidsen
dc.titleHealth-related quality of life in survivors of septic shock: 6-month follow-up from the ADRENAL trial.en
dc.typeJournal Articleen
dc.identifier.journaltitleIntensive Care Medicineen
dc.identifier.affiliationDepartment of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealanden
dc.identifier.affiliationMalcolm Fisher Department of Intensive Care, Royal North Shore Hospital, Sydney, Australiaen
dc.identifier.affiliationRoyal Brisbane and Women's Hospital, Brisbane, Australiaen
dc.identifier.affiliationSt. George's Healthcare NHS Trust, London, UKen
dc.identifier.affiliationThe Wesley Hospital, Brisbane, Australiaen
dc.identifier.affiliationThe University of Queensland, Brisbane, Australiaen
dc.identifier.affiliationPrincess Alexandra Hospital, Brisbane, Australiaen
dc.identifier.affiliationSchool of Medicine and Pharmacology, University of Western Australia, Perth, Australiaen
dc.identifier.affiliationRoyal Perth Hospital, Perth, Australiaen
dc.identifier.affiliationSt. George Hospital, Sydney, Australiaen
dc.identifier.affiliationStatistics Division, The George Institute for Global Health, UNSW Sydney, Newtown, Australiaen
dc.identifier.affiliationAustin Healthen
dc.identifier.affiliationKing Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center, Riyadh, Saudi Arabia..en
dc.identifier.affiliationRigshospitalet, Copenhagen, Denmark..en
dc.identifier.doi10.1007/s00134-020-06169-1en
dc.type.contentTexten
dc.identifier.orcid0000-0002-6559-7747en
dc.identifier.pubmedid32676679
dc.type.austinJournal Article
local.name.researcherBellomo, Rinaldo
item.openairetypeJournal Article-
item.cerifentitytypePublications-
item.grantfulltextnone-
item.fulltextNo Fulltext-
item.openairecristypehttp://purl.org/coar/resource_type/c_18cf-
item.languageiso639-1en-
crisitem.author.deptIntensive Care-
crisitem.author.deptData Analytics Research and Evaluation (DARE) Centre-
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