Measuring the health outcomes of general ICU patients: a systematic review of methods and findings

Abstract

Studies that have measured patient outcomes following a critical illness and admission to a general intensive care unit (ICU) have used a variety of methods and variables. Traditionally, the measures have been mortality and morbidity, but they now also include assessment of indices such as functional status, health status, quality of life and patient satisfaction. This review paper examines 31 previously published primary studies that measured patient outcomes from adult general ICUs. Inclusion criteria for the review process included papers with explicit measurement of patient outcomes beyond mortality rates: functional status, health status and quality of life. The paper includes summative descriptions of the reviewed papers, discussion of the various methods, results and limitations, and some synthesis of the pooled findings. The review indicated that the health status and activities of the majority of survivors who responded to the follow-up measures were similar to what they were before their critical illness. However, whether these subjects are representative of ICU survivors in general is not conclusive, as lack of methodological control over exclusions and losses to follow-up were evident. In addition, the heterogeneity of the ICU population in terms of age, acuity and diagnoses complicates any potential comparisons. There is an opportunity for further studies in this area by nurse researchers, in either intra- or multidisciplinary teams. Future studies should incorporate rigorous methodologies and a triangulated approach, in order to adequately examine patient outcomes following a critical illness and admission to a general ICU.