Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors.

Abstract

To evaluate functional status and quality of life in elderly intensive care unit (ICU) survivors at 1-year follow-up. Prospective 18-month observational study. University medical-surgical ICU. ICU survivors aged 75 and older. Functional status at baseline (Barthel Index (BI)) was compared with that at hospital discharge and 1-year follow-up. Health-related quality of life (HRQL Spanish version of the Medical Outcomes Study 36-item Short-From Survey) was measured at 1-year follow-up and compared with that of the Spanish population of same age. Of 176 individuals admitted to the ICU, 110 (62.1%) were discharged alive from the hospital, and 94 (53.1%) were alive at 1-year follow-up. ICU admission was associated with significant clinical deterioration (median BI 100 points (interquartile range (IQR) 85-100) at baseline vs 85 (IQR 60-100) at hospital discharge, P<.001). Three months after discharge, there was a significant although modest improvement in functional status (BI 95 (IQR 80-100) P=.03). Baseline functional status was not recovered at 1-year follow-up (BI 95 (IQR 80-100) P<.001). More ICU survivors had moderate to severe dependence at the end of follow-up (20.3%) than at ICU admission (6.6%) (P<.001). Factors independently associated with poor functional recovery were low baseline BI and ICU stay longer than 4days. At 1-year follow-up, 76.8% of participants who survived were living in their own homes. HRQL was similar to that of the Spanish population of the same age. Elderly ICU survivors experienced significant deterioration in functional status, and although they recovered modestly during the following year, they never regained their baseline status. Good recovery was associated with short ICU stay and better baseline functional status.