Impact of a Prolonged Surgical Critical Illness on Patients’ Families

Abstract

Long-term effects on patients' families after a prolonged stay in a surgical intensive care unit are unclear. We hypothesized that illnesses requiring more than 7 days' stay in the surgical intensive care unit would have significant, long-lasting effects on patients' families that would be related to patients' functional outcome. All patients who stayed in the general surgery intensive care unit 7 days or more between July 1, 1996, and June 30, 1997, were enrolled. A total of 128 patients met the entry criteria, and families of surviving patients were interviewed at baseline and 1, 3, 6, and 12 months later. Maximum dysfunction/impact was compared with patients' functional outcome. Significant disturbances in the families' lives occurred throughout the 12 months of this study. Almost 60% of responding families provided a moderate or large amount of caregiving between 1 and 9 months after a prolonged illness, 44.9% had to quit work after 1 month, and more than 36.7% of families had lost savings after 1 year. Some families moved to a less expensive home, delayed educational plans, or delayed medical care for another family member. An acute surgical illness that results in a prolonged stay in an intensive care unit has a substantial effect on patients' families that is maximal between 1 and 3 months and parallels the patient's functional outcome. Systems that provide support to both patients and their families should be emphasized in the hospital and after discharge.