Long-term health-related quality of life in survivors of sepsis. Short Form 36: A valid and reliable measure of health-related quality of life

Objective: To describe the long-term health-related quality of life (HRQL) of survivors of sepsis and to evaluate the reliability and validity of the medical outcomes study Short Form-36 (SF-36) in this population. Study Design: Cross-sectional survey. Setting: University intensive care unit. Patients: Surviving patients over the age of 17 yrs who met the criteria fo r the Society of Critical Care Medicine/American College of Chest Physician s definition of sepsis identified through a review of patients admitted to the intensive care unit from 1994 to 1998. Interventions: None. Measurements and Main Results: Baseline demographics and clinical character istics were abstracted from the medical chart. After hospital discharge, th e SF-36 and Patrick's Perceived Quality of Life scale were administered by telephone. The SF-36 was readministered 2 wks later. We screened the charts of 109 patients; 78 had a diagnosis of sepsis. Of these, 31 had died, 3 ha d severe communication problems, 9 refused to participate, and 5 patients c ould not be located. A total of 30 patients completed the first interview; 26 completed the second. Compared with established norms for the U.S. gener al population, survivors of sepsis scored significantly lower on the physic al functioning, role physical, general health, vitality, and social functio ning domains, as well as on the Physical Health Summary Scale. Mean scores on the Mental Health Summary Scale were very similar between the survivors of sepsis and U.S. norms. The SF-36 demonstrated high internal consistency (Cronbach's alpha ranged from 0.65 to 0.94) and excellent test-retest stabi lity (intraclass correlation coefficient ranged from 0.75 to 0.97). Both th e Physical Health Summary Scale and the Mental Health Summary Scale correla ted well with overall Perceived Quality of Life scores (Pearson correlation coefficients 0.45 and 0.56, respectively). Conclusions: The long-term HRQL of survivors of sepsis is significantly low er than that of the general U.S. population. The SF-36 demonstrated good re liability and validity when used to measure HRQL in survivors of sepsis.