Post-traumatic stress disorder and quality of life alterations in survivors of immune-mediated thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome - Université Paris Cité Accéder directement au contenu
Article Dans Une Revue Journal of Critical Care Année : 2023

Post-traumatic stress disorder and quality of life alterations in survivors of immune-mediated thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome

Elie Azoulay
Virginie Souppart
  • Fonction : Auteur
Nancy Kentish-Barnes
  • Fonction : Auteur
Ygal Benhamou
  • Fonction : Auteur
Lara Zafrani
  • Fonction : Auteur
Adrien Joseph
  • Fonction : Auteur
Emmanuel Canet
  • Fonction : Auteur
Claire Presne
  • Fonction : Auteur
Maximilien Grall
  • Fonction : Auteur
Yoann Zerbib
  • Fonction : Auteur
François Provot
  • Fonction : Auteur
Jehane Fadlallah
  • Fonction : Auteur
Eric Mariotte
  • Fonction : Auteur
Tomas Urbina
  • Fonction : Auteur
Agnès Veyradier
  • Fonction : Auteur
Paul Coppo
  • Fonction : Auteur

Résumé

Thrombotic thrombocytopenic purpura (iTTP) and atypical hemolytic-uremic syndrome (aHUS), once in remission, may cause long-term symptoms, among which mental-health impairments may be difficult to detect. We conducted telephone interviews 72 [48-84] months after ICU discharge to assess symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) and the 36-item Short Form questionnaire (SF-36). Of 103 included patients, 52 had iTTP and 51 aHUS; 74% were female, median age was 39 y (31-54), and 39 (38%) patients were still taking treatment. Symptoms of anxiety, PTSD and depression were present in 50%, 27% and 14% of patients, respectively, with no significant difference between the iTTP and aHUS groups. Patients with PTSD symptoms had significantly greater weight gain and significantly worse perceived physical and/or emotional wellbeing, anxiety symptoms, and depression symptoms. The SF-36 physical and mental components indicated significantly greater quality-of-life impairments in patients with vs. without PTSD symptoms and in those with aHUS and PTSD vs. iTTP with or without PTSD. In the aHUS group, quality of life was significantly better in patients with vs. without eculizumab treatment. Factors independently associated with PTSD symptoms were male sex (odds ratio [OR], 0.11; 95%CI, 0.02-0.53), platelet count ≤20 G/L at acute-episode presentation (OR, 2.68; 1.01-7.38), and current treatment (OR, 2.69; 95%CI, 1.01-7.36). Mental-health screening should be routine in patients with iTTP and aHUS to ensure appropriate care.
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Dates et versions

hal-04086959 , version 1 (02-05-2023)

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Elie Azoulay, Virginie Souppart, Nancy Kentish-Barnes, Ygal Benhamou, Bérangère S Joly, et al.. Post-traumatic stress disorder and quality of life alterations in survivors of immune-mediated thrombotic thrombocytopenic purpura and atypical hemolytic and uremic syndrome. Journal of Critical Care, 2023, 76, pp.154283. ⟨10.1016/j.jcrc.2023.154283⟩. ⟨hal-04086959⟩
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