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Long-term outcomes after severe shock.

Cristina M Pratt1, Eliotte L Hirshberg, Jason P Jones

  • 1*Pulmonary and Critical Care Medicine, Intermountain Medical Center; †Center for Humanizing Critical Care, Intermountain Healthcare; and ‡Division of Pediatric Critical Care, University of Utah, Salt Lake City, Utah; §Kaiser-Permanente Southern California, Pasadena, California; ∥Homer Warner Center for Informatics Research, Intermountain Healthcare, Murray, Utah; ¶Pulmonary and Critical Care Medicine, University of Utah School of Medicine, Salt Lake City, Utah; and **Psychology Department and Neuroscience Center, Brigham Young University, Provo, Utah.

Shock (Augusta, Ga.)
|November 14, 2014
PubMed
Summary
This summary is machine-generated.

Survivors of severe shock demonstrate high long-term survival rates. Their physical and mental health outcomes are comparable to other critical illness survivors, indicating acute severity doesn't dictate long-term prognosis.

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Area of Science:

  • Critical Care Medicine
  • Intensive Care Unit (ICU) Outcomes
  • Post-Intensive Care Syndrome Research

Background:

  • Severe shock carries a high short-term mortality risk.
  • Long-term outcomes for severe shock survivors compared to other critical illnesses are not well-established.
  • Understanding long-term prognosis is crucial for comprehensive critical care management.

Purpose of the Study:

  • To assess long-term survival and functional outcomes in 90-day severe shock survivors.
  • To identify clinical predictors associated with these long-term outcomes.
  • To compare outcomes with general intensive care unit survivor populations.

Main Methods:

  • Prospective study of 76 patients alive 90 days post-severe shock.
  • Assessment of 3-year survival and long-term functional status using validated surveys (SF-36, EuroQOL 5-D-3L, HADS, IES-R, employment status).
  • Telephone interviews conducted a mean of 5 years post-hospital admission.

Main Results:

  • 82% of patients survived 90 days; mean long-term survival was 5.1 years.
  • Physical functioning scores were below population norms, while mental health scores were similar.
  • High prevalence of anxiety (39%) and depression (19%); low PTSD (8%). 36% disabled, 17% employed full-time.

Conclusions:

  • Early survivors of severe shock exhibit favorable long-term survival rates.
  • Long-term physical and psychological outcomes are comparable to less severely ill ICU survivors.
  • Acute illness severity does not solely determine long-term patient outcomes.