• Damien Contou, Florence Canoui-Poitrine, Rémi Coudroy, Sébastien Préau, Martin Cour, François Barbier, Nicolas Terzi, Guillaume Schnell, Arnaud Galbois, Lara Zafrani, Benjamin Zuber, Stephan Ehrmann, Elodie Gelisse, Delphine Colling, Matthieu Schmidt, Samir Jaber, Alexandre Conia, Romain Sonneville, Gwenhaël Colin, Laurent Guérin, Damien Roux, Sébastien Jochmans, Nancy Kentish-Barnes, Etienne Audureau, Richard Layese, Aline Alves, Rachida Ouedraogo, Christian Brun-Buisson, Armand Mekontso Dessap, Nicolas de Prost, and Hopeful Study Group.
• Service de Réanimation Médicale, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil.
• Clin. Infect. Dis. 2019 Jul 2; 69 (2): 332-340.

BackgroundLong-term health-related quality of life (HR-QOL) of patients surviving the acute phase of purpura fulminans (PF) has not been evaluated.MethodsThis was a French multicenter exposed-unexposed cohort study enrolling patients admitted in 55 intensive care units (ICUs) for PF from 2010 to 2016. Adult patients surviving the acute phase of PF (exposed group) were matched 1:1 for age, sex, and Simplified Acute Physiology Score II with septic shock survivors (unexposed group). HR-QOL was assessed during a phone interview using the 36-Item Short-Form Health Survey (SF-36) questionnaire, the Hospital Anxiety and Depression (HAD) scale, the Impact of Event Scale-Revised (IES-R), and the activity of daily living (ADL) and instrumental ADL (IADL) scales. The primary outcome measure was the physical component summary (PCS) of the SF-36 questionnaire.ResultsThirty-seven survivors of PF and 37 of septic shock were phone-interviewed at 55 (interquartile range [IQR], 35-83) months and 44 (IQR, 35-72) months, respectively, of ICU discharge (P = .23). The PCS of the SF-36 was not significantly different between exposed and unexposed patients (median, 47 [IQR, 36-53] vs 54 [IQR, 36-57]; P = .18). There was also no significant difference between groups regarding the mental component summary of the SF-36, and the HAD, IES-R, ADL and IADL scales. Among the 37 exposed patients, those who required limb amputation (n = 12/37 [32%]) exhibited lower PCS (34 [IQR, 24-38] vs 52 [IQR, 42-56]; P = .001) and IADL scores (7 [IQR, 4-8] vs 8 [IQR, 7-8]; P = .021) compared with nonamputated patients.ConclusionsLong-term HR-QOL does not differ between patients surviving PF and those surviving septic shock unrelated to PF. Amputated patients have an impaired physical HR-QOL but a preserved mental health.Clinical Trials RegistrationNCT03216577.© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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