Abstract
Objective
To determine survival and changes in quality of life (QOL) after hospital discharge in patients who had stayed in an intensive care unit (ICU).
Design
Prospective study by direct interviews during ICU stay and 6 months after hospital discharge.
Setting
Surgical-medical ICU.
Patients and methods
We interviewed cooperative, adult patients admitted consecutively to the ICU for more than 24 h, living near the hospital, who gave informed consent. The following QOL domains were investigated: residence, physical activity, social life, perceived QOL, oral communication and functional limitation.
Results
One-year survival was 82.4% (predicted 84%). Mortality was 36.3% after urgent neoplastic surgery, 19.4% for medical admissions and 4.9% after non-neoplastic surgery. Of 160 patients studied, eight cases, older and already deteriorated at the first interview, could not respond to the perceived QOL item after ICU discharge. In the other 152 patients, physical activity was reduced in 31% (usually slightly), social life had worsened in 32% and functional limitation increased in 30%. The perceived QOL did not change.
Conclusions
After hospital discharge, the survival of ICU-admitted patients is comparable to that of the general population and not related to ICU treatments. Most patients maintain their physical activity and social status at the preadmission level. Any worsening, if present, is slight and does not influence perceived QOL.
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References
Consensus conference organised by the ESICM and the SRLF (1994) Predicting outcome in ICU patients. Intensive Care Med 20:390–397
Jacobs CJ, van der Vliet JA, van Roozendaal MT, van der Linden CJ (1988) Mortality and quality of life after intensive care for critical illness. Intensive Care Med 14:217–220
Vazquez Mata G, Rivera Fernandez R, Gonzales Carmona A, Delgado-Rodriguez M, Torres Ruiz JM, Raya Pugnaire A, Aguayo de Hoyos E (1992) Factors related to quality of life 12 months after discharge from an intensive care unit. Crit Care Med 20:1257–1262
Gill TM, Feinstein AR (1994) A critical appraisal of the quality of quality of life measurements. JAMA 272: 619–626
Sage WM, Rosenthal MH, Silverman JF (1986) An assessment of input and outcome for the critically ill. Crit Care Med 14:777–782
Mundt DJ, Gage RW, Lemeshow S, Pastides H, Teres D, Avrunin JS (1989) Intensive care unit patients follow-up: mortality, functional status, and return to work at six months. Arch Intern Med 149:68–72
Ridley AA, Wallace PGM (1990) Quality of life after intensive care. Anaesthesia 45:808–813
Rockwood K, Noseworthy TW, Gibney NRT, Konopad E, Shustack A, Stollery D, Johnston R, Grace M (1993) One-year outcome of elderly and young patients admitted to intensive care units. Crit Care Med 21:687–691
Goldstein RL, Campion EW, Thibault GE, Mulley AG, Skinner E (1986) Functional outcomes following medical intensive care. Crit Care Med 14: 783–788
Mahul P, Perrot D, Tempelhoff G, Gaussorgues P, Jospe R, Ducreux JC, Dumont A, Motin J, Auboyer C, Robert D (1991) Short- and long-term prognosis, functional outcome following ICU for elderly. Intensive Care Med 17:7–10
Yinnon A, Zimran A, Hershko C (1989) Quality of life and survival following intensive medical care. Q J Med 264:347–357
Le Gall JR, Lemeshow S, Saulnier F (1993) A new simplified acute physiology score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957–2963
Knaus WA, Draper EA, Wagner DP, Zimmerman JE (1985) Apache II: a severity of disease classification system. Crit Care Med 13:818–829
Spanish Group for the Epidemiological Analysis of Critical Patients (1994) Quality of life: a tool for decision-making in the ICU. Intensive Care Med 20: 251–252
Fitzpatrick R, Fletcher A, Gore S, Jones D, Spiegelhalter D, Cox D (1992) Quality of life measures in health care. I: applications and issues in assessment. BMJ 305:1074–1077
Fletcher A, Gore S, Jones D, Fitzpatrick R, Spiegelhalter D, Cox D (1992) Quality of life measures in health care. II., design, analysis and interpretation. BMJ 305:1145–1148
Guyatt GH, Feeny D, Patrick DL (1993) Measuring health-related quality of life. Ann Intern Med 118:622–629
Tian ZM, Reis Miranda D (1995) Quality of life after intensive care with the sickness impact profile. Intensive Care Med 21:422–428
Wassertheil-Smoller S (1990) Biostatistics and epidemiology. Springer, Berlin Heidelberg New York, pp 86–103
Knapp TR (1991) Coefficient alpha: conceptualizations and anomalies. Res Nurs Health 14:457–460
Zarén B, Bergström R (1989) Survival compared to the general population and changes in health status among intensive care patients. Acta Anaesthesiol Scand 33:6–12
Dragsted L, Qvist J, Madsen M (1990) Outcome from intensive care. IV. A 5-year study of 1308 patients: long term outcome. Eur J Anaesthesiol 7:51–62
Løes O, Smith-Erichsen N, Lind B (1987) Intensive care: cost and benefit. Acta Anaesthesiol Scand 31S:3–19
Ridley S, Biggam M, Stone P (1994) A cost-utility analysis of intensive therapy. II. quality of life in survivors. Anaesthesia 49:192–196
Mayer-Oakes AS, Oye RK, Leake B (1991) Predictors of mortality in older patients following medical intensive care: the importance of functional status. J Am Geriatr Soc 39:862–868
Dragsted L, Qvist J (1989) Outcome from intensive care. III. A 5-year study of 1308 patients: activity levels. Eur J Anaesthesiol 6:385–396
Guyatt GH, Cook DJ (1994) Health status, quality of life, and the individual. JAMA 272:630–631
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Capuzzo, M., Bianconi, M., Contu, P. et al. Survival and quality of life after intensive care. Intensive Care Med 22, 947–953 (1996). https://doi.org/10.1007/BF02044121
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DOI: https://doi.org/10.1007/BF02044121