Quality of life assessment following amputation for septic shock: a long-term descriptive survey after symmetric peripheral gangrene.
PURPOSE
To assess health-related quality of life (HRQOL) following rehabilitation of amputees suffering symmetric peripheral gangrene (SPG) after septic shock.


MATERIAL AND METHODS
A retrospective cohort study was conducted in nine French specialized rehabilitation centers. Thirty-two ICU adult patients hospitalized between 2005 and 2015 for septic shock who additionally presented with SPG resulting in at least two major amputations were enrolled. HRQOL was assessed by EQ-5D-3 L questionnaire.


RESULTS
All patients (mean ICU length of stay 39 ± 22d, SAPS II 58 ± 18) had both lower limbs amputated and 84% were quadruple amputees. HRQOL, assessed 4.8 ± 2.8 years after amputation, was inferior to the French reference. However, patients' self-rated health status was similar to the reference at the time of HRQOL assessment. The main factor of impaired HRQOL was intense phantom pain, not the mobility or self-care dimensions of EQ-5D. All patients except one preferred to be treated again for SPG despite disability.


CONCLUSION
ICU survivors referred to rehabilitation centers after SPG-related amputations had impaired HRQOL. At the time of HRQOL assessment, they considered themselves in good health and preferred to be treated again despite disability. Appraisal of long-term functional outcome should not be used to guide end-of-life decision-making in this situation.
['Labroca|Pierre|P|', 'Chiesa|Gérard|G|', 'Laroyenne|Isabelle|I|', 'Borrini|Léo|L|', 'Klotz|Rémi|R|', 'Phan Sy|Quoc|Q|', 'Cristina|Marie-Christine|MC|', 'Martinez|Anne Brunon|AB|', 'Bollaert|Pierre-Edouard|PE|', 'Paysant|Jean|J|', 'Lemarié|Jérémie|J|']
D000328:Adult D000368:Aged D000671:Amputation D001132:Arm D005260:Female D005734:Gangrene D006304:Health Status D006801:Humans D007866:Leg D008297:Male D008875:Middle Aged D011788:Quality of Life D012189:Retrospective Studies D012772:Shock, Septic D011795:Surveys and Questionnaires D017741:Survivors
Septic shock HRQOL Ethics