Surviving meningococcal septic shock in childhood long-term overall outcome and the effect on health-related quality of life 英文参考文献.docVIP

Buysse et al. Critical Care 2010, 14:R124 /content/14/3/R124 RESEARCH Open Access Surviving meningococcal septic shock in Research childhood: long-term overall outcome and the effect on health-related quality of life Corinne MP Buysse*1, Lindy CAC Vermunt2, Hein Raat3, Jan A Hazelzet1, Wim CJ Hop4, Elisabeth MWJ Utens2 and Koen FM Joosten1 Abstract Introduction: The purpose of this study was to evaluate associations between long-term physical and psychological outcome variables in patients who survived meningococcal septic shock (MSS) in childhood. Methods: The study population was made up of all MSS patients requiring intensive care treatment between 1988 and 2001. Results: A total of 120 patients visited the follow-up clinic (age at paediatric intensive care unit (PICU) admission 3.1 years; follow-up interval 9.8 years; age at follow-up 14.5 years (all medians)). Four major outcomes were considered: 1) major physical sequelae (defined as major scars and/or orthopaedic sequelae) (29/120), 2) mild neurological impairments (39/120), 3) problem behaviour (defined as a total score above the 90th percentile of the reference groups on questionnaires to screen for psychopathology) (16/114) and 4) total intelligence quotient 85 (18/115). No differences were found between patients with major physical sequelae and patients without major physical sequelae as to the presence of problem behaviour or total IQ 85. Also, no differences were found between patients with mild neurological impairments and patients without as to the presence of problem behaviour or total IQ 85. Finally, no differences were found between patients with major physical sequelae and patients without as to the presence of mild neurological sequelae. Less favourable scores on behavioural and emotional problems were significantly associated with poorer health-related quality of life (HR-QoL). HR-QoL scores were to a lesser amount predicted by severity of illness at time of PICU admission or