The Association Between Days Alive and Out of Hospital and Health-Related Quality of Life in Patients With Sepsis

Anthony Delaney; David H. Tian; Alisa M. Higgins; Jeffrey Presneill; Sandra Peake; Balasubramanian Venkatesh; John Myburgh; Simon Finfer; Kelly Thompson; Colman Taylor; Lachlan Donaldson; Joseph Alvin Santos; Naomi Hammond

doi:10.1016/j.chstcc.2023.100024

October 7, 2023CHEST Critical CareOpen Access

The Association Between Days Alive and Out of Hospital and Health-Related Quality of Life in Patients With Sepsis

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Key Points

To evaluate the association between days alive and out of hospital at day 90 (DAOH-90) and health-related quality of life at 6 months, and to assess the construct validity of DAOH-90 as an outcome measure in patients with sepsis.
Secondary pooled analysis of 6,213 participants with sepsis from three randomized clinical trials (ADRENAL, ARISE, and CHEST; ClinicalTrials.gov NCT04567433).
DAOH-90 was calculated by subtracting acute care hospital days up to day 90 from 90, with 0 assigned to patients dying prior to day 90.
Health-related quality of life at 6 months was measured via the EQ-5D utility index and EQ-5D visual analog scale, analyzed using linear, nonlinear, and nonparametric models adjusted for baseline covariates.
Among 6,213 participants, median index hospital length of stay was 16 days (IQR, 8-30), in-hospital mortality was 22.6% (1,402/6,213), and median DAOH-90 was 60 days (IQR, 0-77).
Each additional DAOH-90 was significantly associated with an increase in the 6-month EQ-5D utility index score of 0.01 (95% CI, 0.01-0.011; P < .001).
Adjusted regression demonstrated that each additional DAOH-90 increased the 6-month EQ-5D visual analog scale score by 1.01 points (95% CI, 0.99-1.04; P < .001), while higher baseline risk factors were associated with fewer DAOH-90.

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Implication

Study pooled analysis reveals higher days alive and out of hospital correlates with improved 6-month quality of life in sepsis, supporting its use as a trial endpoint.

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Delaney et al. (2023) studied this question.

synapsesocial.com/papers/6a1268d5965b75813866f1b0 https://doi.org/10.1016/j.chstcc.2023.100024

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The Association Between Days Alive and Out of Hospital and Health-Related Quality of Life in Patients With Sepsis

Key Points

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The Association Between Days Alive and Out of Hospital and Health-Related Quality of Life in Patients With Sepsis

Key Points

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