Analysis of quality of life in polytraumatized patients two years after discharge from an intensive care unit.

Abstract

Analysis of quality of life of polytraumatized critical care patients. Prospective study. Patients admitted in a 2-year period in a traumatologic intensive care unit (ICU) were evaluated. A quality of life questionnaire was completed on admission (N = 351), 1 year and 2 years after discharge from the ICU. The three questionnaires evaluated patients' ability to function and communicate over the previous 2 months. A quality of life score of 0 corresponded to no limitations. Quality of life was also evaluated by the Glasgow Outcome Scale. Information was collected on the severity of illness and the diagnosis prompting ICU admission. The mean quality of life score of survivors worsened from 0.46 +/- 0.11 points on ICU admission to 6.68 +/- 0.41 1 year after discharge, and then improved to 4.86 +/- 0.38 2 years after discharge, although the quality of life score continued to be worse than on admission (p < 0.001). On admission, 93.2% of patients had normal quality of life (0 points), after 1 year 36.5% were normal, and after 2 years 51.6% were normal. Three patients (0.9%) remained in vegetative state. On admission, 96.6% were working, while after 2 years, only 57.5% had returned to employment, although the high levels of unemployment in our country during this study may have been a particular factor in this result. All age groups except pediatric patients showed a worsened quality of life after 2 years, and patients over 60 years had worst scores on admission and after 1 and 2 years. Patients with least severity by Acute Physiology and Chronic Health Evaluation (APACHE) II score (< 10 points) had a better quality of life score after 1 and 2 years. Severity by Injury Severity Score showed patients with > 25 points having the greatest deterioration in quality of life. A multivariate study showed that quality of life after 2 years is influenced by age, severity of injury, and previous quality of life. Polytraumatized patients admitted into ICU showed a worsening of their quality of life 1 and 2 years after ICU discharge, with an improvement between 1 and 2 years. Quality of life after 2 years is influenced by age, severity of illness, and previous quality of life.