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Citation
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Haug VF, Tapking C, Panayi AC, Thiele P, Wang AT, Obed D, Hirche C, Most P, Kneser U, Hundeshagen G. J. Trauma Acute Care Surg. 2021; ePub(ePub): ePub. |
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Abstract
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BACKGROUND: Sepsis, major trauma and severe burn injury are life-threatening critical illnesses that remain significant contributors to worldwide morbidity and mortality. The three underlying etiologies share pathophysiological similarities: hyperinflammation, hypermetabolism, and acute immunomodulation. The aim of this study is to assess the current state of long-term outcome research, and to identify key outcome parameters between the three forms of critical illness.
METHODS: This systematic review (SR) and meta-analysis (MA) were conducted according to the PRISMA guidelines. PubMed was searched from January 1st, 1975 to December 31st, 2019. Studies were assessed for eligibility by independent reviewers. Inclusion criteria were studies reporting at least a 6-month follow-up of health-related quality of life (HRQoL), and organspecific sequelae within the three etiologies: severe burn injury, sepsis, and major trauma.
RESULTS: In total 125 articles could be included in the SR and 74 in the MA. The mean follow-up time was significantly longer in burn studies, compared to sepsis and trauma studies. The majority of patients were from the sepsis group, followed by burns, and major trauma studies. In the overall HRQoL, as assessed by ShortForm-36, and European Quality-of-Life Index, the three different etiologies were comparable to one another.
CONCLUSION: The effects of critical illness on survivors persist for years after hospitalization. Well-reported and reliable data on the long-term outcomes are imperative, as they can be used to determine the treatment choice of physicians as well as to guide the expectations of patients, improving the overall quality of care of three significant patient cohorts. LEVEL OF EVIDENCE: III.
Language: en |