Diagnosis of brain death, back to medical diagnosis!

Abstract

Advances in critical care medicine have improved patients’ survival rate. However, physical and cognitive sequels after Intensive Care Unit (ICU) discharge remain substantial. Our objectives were to evaluate the Health-related Quality of Life (HRQL) at 6-month after ICU discharge and identify the risk factors of this outcomes.We performed a single-centre prospective observational study. The components of Short Form 36 (SF-36) were analysed for assessing HRQL on preadmission and at 3- and 6-month after ICU discharge.During the study period, 438 patients were eligible for recruitment and 220 of them were included in the trial. During the follow-up period, bodily pain and role limitations relating to emotion were both improved in comparison to the preadmission status while physical role component was lower at 3- and 6- month after ICU discharge. There was no other significant change in the SF-36 domains. Mental as well as physical aggregates remained also unchanged. Most of preadmission SF-36 scores were lower in patients who died within the first 6 months of follow-up compared to those who are still alive. Factors independently associated with the 6-month HRQL were age, preadmission HRQL score, SAPS II, prolonged mechanical ventilation (> 3 days) and the occurrence of acute respiratory distress syndrome.In our Cohort, ICU stay does not seem to alter globally neither the mental nor the physical component of the HRQL at 6-month after the discharge. However, some domains of the SF-36 are subject to significant changes.