Abstract
BackgroundIntensive care patients have, both before and after the ICU stay, a health-related quality of life (HRQOL) that differs from that of the normal population. Studies have described changes in HRQOL in the period from before the ICU stay and up to 12 months after. The aim of this study was to investigate possible longitudinal changes in HRQOL in adult patients (>18 years) from 6 months to 2 years after discharge from a general, mixed intensive care unit (ICU) in a university hospital.MethodsThis is a prospective cohort study. Follow-up patients were found using the ICU database and the Peoples Registry. HRQOL was measured with the Short Form 36 (SF-36) questionnaire. Answers at 6 months and 2 years were compared for all patients, surgical and medical patients, and different admission cohorts.Differences are presented with 95% confidence intervals. The SF-36 data were scored according to designed equations. SPSS 11.0 was used to perform t-tests and Mann-Whitney tests.ResultsA total of 100 patients (26 medical and 74 surgical) answered the SF-36 after 6 months and again after 2 years. There was overall moderate improvement in 6 out of 8 dimensions of the SF-36, and the average increase in score was + 4.0 for all 8 dimensions. The changes for surgical and medical patients were similar. Neurological and respiratory patients reported increased average HRQOL scores, while cardiovascular patients did not. Patients with worsening of scores from 6 months to 2 years were insignificantly older than patients with improved scores (55.3 vs. 49.7 years), and both groups had comparable severity scores (simplified acute physiology score, SAPS II, 37.2 vs. 36.3) and length of ICU stay (2.7 vs. 3.2 days). The statistically significant changes in HRQOL (in the Role Physical and Social Functioning dimensions) were, due to sample size, barely clinically relevant.ConclusionIn a mixed ICU population we found moderate increases in HRQOL both for medical and surgical patients from 6 months to 2 years after ICU discharge, but the sample size is a limitation in this study.
Highlights
Intensive care patients have, both before and after the intensive care unit (ICU) stay, a health-related quality of life (HRQOL) that differs from that of the normal population
Patients with worsening of scores from 6 months to 2 years were insignificantly older than patients with improved scores (55.3 vs. 49.7 years), and both groups had comparable severity scores and length of ICU stay (2.7 vs. 3.2 days)
Four were in the ICU for pure observational reasons, 31 died within 6 months after ICU discharge, 9 were lost to follow-up, 126 answered the Social Functioning (SF)
Summary
Both before and after the ICU stay, a health-related quality of life (HRQOL) that differs from that of the normal population. The aim of this study was to investigate possible longitudinal changes in HRQOL in adult patients (>18 years) from 6 months to 2 years after discharge from a general, mixed intensive care unit (ICU) in a university hospital. Intensive care patients have a higher mortality than the normal population up to 1–2 years after ICU discharge, but from that time further survival is comparable [1,2,3]. Health-related quality of life (HRQOL) is an important outcome measure after intensive care. Quality of life studies are often difficult to compare, since different intensive care populations have been studied and a variety of quality of life measures have been used, at different times after ICU discharge. The practice of intensive care varies [8]
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