Changes in quality of life after medical intensive care

Abstract

Objectives: To determine outcome and changes in health-related quality of life (QOL) in medical intensive care patients.

Design and setting: Prospective comparison of QOL before and 6 months after intensive care unit (ICU) admission in a 12-bed noncoronary medical ICU of a university hospital.

Patients: All 325 consecutively admitted adult patients who spent at least 24 h on the ICU were eligible.

Measurements and results: QOL measurements were collected before and 6 months after ICU admission. Comorbidity classified by the Charlson index was 2.44 +/- 1.96. Mean stay in the ICU was 10.4 +/- 15.1 days, mean Acute Physiology and Chronic Health Evaluation II score was 23 +/- 10. Cumulative mortality was: ICU 24 %, hospital 34 %, 6 months 43 %. Relative to baseline, follow-up interviews of 185 survivors revealed no significant changes in the overall QOL score (p = 0.93). The subscales basic physiological activities (p = 0.07) and normal daily activities (p = 0.15) showed a nonsignificant deterioration. A significant improvement was noted for the domain emotional state (p = 0.013).

Conclusions: Six months after admission to a medical ICU most survivors had regained their preadmission health-related QOL. Multivariate analysis showed that preadmission QOL, age, and severity of illness were most strongly associated with follow-up QOL. Of the survivors 86 % were living at home, and all but one of those previously in employment had returned to their former work. Most patients (94%) would undergo ICU treatment again if necessary.