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Observational Study
. 2022 Feb 2;51(2):afab278.
doi: 10.1093/ageing/afab278.

Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70 years

Ivo W Soliman  1 , Susannah Leaver  2 , Hans Flaatten  3 , Jesper Fjølner  4 , Bernhard Wernly  5 , Raphael R Bruno  6 , Antonio Artigas  7 , Bernardo Bollen Pinto  8 , Joerg C Schefold  9 , Michael Beil  10 , Sigal Sviri  10 , Peter Vernon van Heerden  11 , Wojciech Szczeklik  12 , Muhammed Elhadi  13 , Michael Joannidis  14 , Sandra Oeyen  15 , Tilemachos Zafeiridis  16 , Jakob Wollborn  17 , Maria Jose Arche Banzo  18 , Kristina Fuest  19 , Brian Marsh  20 , Finn H Andersen  21   22 , Rui Moreno  23 , Ariane Boumendil  24   25 , Bertrand Guidet  24   25 , Christian Jung  6 , Dylan W De Lange  1 ; COVIP-study group
Collaborators, Affiliations
Observational Study

Health-related quality of life in older patients surviving ICU treatment for COVID-19: results from an international observational study of patients older than 70 years

Ivo W Soliman et al. Age Ageing. .

Abstract

Background: health-related quality of life (HRQoL) is an important patient-centred outcome in patients surviving ICU admission for COVID-19. It is currently not clear which domains of the HRQoL are most affected.

Objective: to quantify HRQoL in order to identify areas of interventions.

Design: prospective observation study.

Setting: admissions to European ICUs between March 2020 and February 2021.

Subjects: patients aged 70 years or older admitted with COVID-19 disease.

Methods: collected determinants include SOFA-score, Clinical Frailty Scale (CFS), number and timing of ICU procedures and limitation of care, Katz Activities of Daily Living (ADL) dependence score. HRQoL was assessed at 3 months after ICU admission with the Euro-QoL-5D-5L questionnaire. An outcome of ≥4 on any of Euro-QoL-5D-5L domains was considered unfavourable.

Results: in total 3,140 patients from 14 European countries were included in this study. Three months after inclusion, 1,224 patients (39.0%) were alive and the EQ-5D-5L from was obtained. The CFS was associated with an increased odds ratio for an unfavourable HRQoL outcome after 3 months; OR 1.15 (95% confidence interval (CI): 0.71-1.87) for CFS 2 to OR 4.33 (95% CI: 1.57-11.9) for CFS ≧ 7. The Katz ADL was not statistically significantly associated with HRQoL after 3 months.

Conclusions: in critically ill old intensive care patients suffering from COVID-19, the CFS is associated with the subjectively perceived quality of life. The CFS on admission can be used to inform patients and relatives on the risk of an unfavourable qualitative outcome if such patients survive.

Keywords: COVID-19; Intensive Care Unit (ICU); Older people; Quality of Life; Survival; frailty.

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Figures

Figure 1
Figure 1
Flow of patients.
Figure 2
Figure 2
Association between CFS and severe or worse complaints on any of the 5 domains of the Quality of Life questionnaire. Percentage of patients complaining of any impairment more than or equal to level 4 answer (‘I have severe complaints…’) on one of the 5 domains of the Health-Related Quality of Life questionnaire (EuroQoL-5D-5L). Based on data after multiple imputation.
Figure 3
Figure 3
Spider graph depicting outcome of quality of life in non-frail, pre-frail and frail patients. Patients with a CFS 1-3 are considered ‘non-frail’ (green line). Patients with a CFS 4-5 are considered ‘pre-frail’ (purple line) and patients with CFS 7+ are considered ‘frail’ (orange line). On the QoL domains, 1 denotes ‘no problems’, 2 ‘slight problems’, 3 ‘moderate problems’, 4 ‘severe problems’ and 5 ‘extreme problems’.
See this image and copyright information in PMC

References

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