Abstract
Many Intensive Care (ICU) survivors experience long lasting impairments in physical and psychological health as well as social functioning. The objective of our study was to evaluate these effects up to 10 years after ICU discharge. We performed a long-term prospective cohort study in patients admitted for longer than 48 h in a medical-surgical ICU. We evaluated health-related quality of life (HRQOL) before ICU admission using the Short-form-36 (SF-36), at ICU discharge, at hospital discharge and at 1, 2, 5 and 10 years follow up (all by patients). Changes in HRQOL were assessed based on linear mixed modeling. We included a total of 749 patients (from 2000 to 2008). During 10 years 475 (63.4%) patients had died, 125 (16.7%) patients were lost to follow up and 149 (19.9%) patients could be evaluated. The mean scores of four HRQOL dimensions (i.e., physical functioning (p < 0.001; mean 54, SD 32, effect size 0.77, 95% CI [0.54–1.0]), role-physical (p < 0.001; mean 44, SD 47, effect size 0.65, 95% CI [0.41–0.68] general health (p < 0.001; mean 52, SD 27, effect size 0.48; 95% CI 0.25–0.71) and social functioning (p < 0.001; mean 72, SD 32, effect size 0.41, 95% CI [0.19–0.64]) were still lower 10 years after ICU discharge compared with pre-admission levels (n = 149) and with an age reference population. Almost all SF-36 dimensions changed significantly over time from ICU discharge up to 10 years after ICU discharge. Over the 10 year follow up physical functioning of medical-surgical ICU survivors remains impaired compared with their pre-admission values and an age reference population. However, effect sizes showed no significant differences suggesting that surviving patients largely regained their age-specific HRQOL at 10 years.
Highlights
Abbreviations intensive care unit (ICU) Intensive care unit IQR Interquartile range (P25-P75) HRQOL Health-related quality of life SF-36 Short form-36
Health-related quality of life (HRQOL) after ICU stay is frequently evaluated at 6 months after the critical illness which may result in recall bias[5,6,7]
We hypothesized that 10 years after ICU discharge, perceived HRQOL of survivors is comparable to their pre-admission level and an age reference population
Summary
Abbreviations ICU Intensive care unit IQR Interquartile range (P25-P75) HRQOL Health-related quality of life SF-36 Short form-36. There are a growing number of survivors of critical illness due to the aging population and with lower numbers of short term mortality in the intensive care unit (ICU)[1,2]. To use a Dutch reference general population[13] Despite these drawbacks, HRQOL remains the most commonly reported long-term outcome after critical illness. HRQOL remains the most commonly reported long-term outcome after critical illness Most of these studies performed in general ICU patients after ICU discharge did not exceed a follow up period of 2–5 years, nor did they evaluate the HRQOL before the patients became seriously ill and were admitted to the ICU14–16. We hypothesized that 10 years after ICU discharge, perceived HRQOL of survivors is comparable to their pre-admission level and an age reference population. We compared the HRQOL of the surviving patients with an age reference population
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