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危重症成年脓毒症幸存者的健康相关生活质量:一项系统综述

Health-Related Quality of Life of Adult Sepsis Survivors Following Critical Illness: A Systematic Review.

作者信息

De Silva Sheraya, Urwin Anna, Grimwood Chantal, Goh Ethan K E, Higgins Alisa M, Hodgson Carol L

机构信息

Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Department of Physiotherapy, Alfred Health, Melbourne, VIC, Australia.

出版信息

Crit Care Explor. 2025 Mar 26;7(4):e1238. doi: 10.1097/CCE.0000000000001238. eCollection 2025 Apr 1.

Abstract

OBJECTIVE

As survival following sepsis improves, there is increased attention on the health-related quality of life (HRQoL) of survivors following critical illness. The aim of this study is to systematically review the literature on the HRQoL of adult sepsis survivors following critical illness.

DATA SOURCES

OVID MEDLINE, Embase, and CINAHL were searched using a combination of MeSH subject headings and keywords.

STUDY SELECTION

English-language studies published between January 2009 and June 2024, which investigated the HRQoL of adult sepsis survivors at 90 days or more following critical illness.

DATA EXTRACTION

Extracted data from included studies comprised HRQoL findings, the instruments administered, and representation of adult survivors following critical illness. Risk-of-bias quality assessment was assessed using the Cochrane Risk of Bias In Non-Randomised Studies - of Exposure tool. Selection of studies, data extraction, and quality assessment were conducted independently by two reviewers.

DATA SYNTHESIS

Thrity-three eligible studies were yielded from 25,611 records, with the sample size among included studies ranging from 55 to 2,151 participants. Included studies were mostly conducted in Europe. The EuroQol 5-dimension three-level instrument was most commonly administered (19 [58%] studies). Our review found that adult sepsis survivors following critical illness have lower HRQoL than population norms, regardless of follow-up timepoint. No significant difference was found in the HRQoL of adult survivors following critical illness with or without sepsis. High risk of bias in included studies was mostly due to missing data and confounding.

CONCLUSIONS

As survival following critical illness improves, future research on improving long-term HRQoL following sepsis is crucial.

摘要

目的

随着脓毒症患者生存率的提高,人们越来越关注危重症幸存者的健康相关生活质量(HRQoL)。本研究的目的是系统回顾关于危重症成年脓毒症幸存者HRQoL的文献。

数据来源

使用医学主题词表(MeSH)主题词和关键词组合检索OVID MEDLINE、Embase和CINAHL数据库。

研究选择

纳入2009年1月至2024年6月发表的英文研究,这些研究调查了危重症成年脓毒症幸存者在90天或更长时间后的HRQoL。

数据提取

从纳入研究中提取的数据包括HRQoL研究结果、所使用的工具以及危重症成年幸存者的代表性。使用Cochrane非随机研究中暴露偏倚风险工具评估偏倚风险质量。两名审阅者独立进行研究选择、数据提取和质量评估。

数据综合

从25611条记录中筛选出33项符合条件的研究,纳入研究的样本量从55至2151名参与者不等。纳入研究大多在欧洲进行。最常用的工具是欧洲五维健康量表三级版本(19项研究[58%])。我们的综述发现,无论随访时间点如何,危重症成年脓毒症幸存者的HRQoL均低于人群标准。危重症成年幸存者无论是否患有脓毒症,其HRQoL均无显著差异。纳入研究中高偏倚风险主要归因于数据缺失和混杂因素。

结论

随着危重症患者生存率的提高,未来关于改善脓毒症后长期HRQoL的研究至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b72b/11949298/e722205c33c7/cc9-7-e1238-g001.jpg

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