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Multicenter Study
. 2024 Jul 25;28(1):255.
doi: 10.1186/s13054-024-05036-5.

Changes in quality of life 1 year after intensive care: a multicenter prospective cohort of ICU survivors

Lucy L Porter  1   2 , Koen S Simons  2 , Stijn Corsten  3 , Brigitte Westerhof  4 , Thijs C D Rettig  5 , Esther Ewalds  6 , Inge Janssen  7 , Crétien Jacobs  8 , Susanne van Santen  9 , Arjen J C Slooter  10   11 , Margaretha C E van der Woude  12   13 , Johannes G van der Hoeven  1 , Marieke Zegers  1 , Mark van den Boogaard  14
Affiliations
Multicenter Study

Changes in quality of life 1 year after intensive care: a multicenter prospective cohort of ICU survivors

Lucy L Porter et al. Crit Care. .

Abstract

Background: With survival rates of critical illness increasing, quality of life measures are becoming an important outcome of ICU treatment. Therefore, to study the impact of critical illness on quality of life, we explored quality of life before and 1 year after ICU admission in different subgroups of ICU survivors.

Methods: Data from an ongoing prospective multicenter cohort study, the MONITOR-IC, were used. Patients admitted to the ICU in one of eleven participating hospitals between July 2016 and June 2021 were included. Outcome was defined as change in quality of life, measured using the EuroQol five-dimensional (EQ-5D-5L) questionnaire, and calculated by subtracting the EQ-5D-5L score 1 day before hospital admission from the EQ-5D-5L score 1 year post-ICU. Based on the minimal clinically important difference, a change in quality of life was defined as a change in EQ-5D-5L score of ≥ 0.08. Subgroups of patients were based on admission diagnosis.

Results: A total of 3913 (50.6%) included patients completed both baseline and follow-up questionnaires. 1 year post-ICU, patients admitted after a cerebrovascular accident, intracerebral hemorrhage, or (neuro)trauma, on average experienced a significant decrease in quality of life. Conversely, 11 other subgroups of ICU survivors reported improvements in quality of life. The largest average increase in quality of life was seen in patients admitted due to respiratory disease (mean 0.17, SD 0.38), whereas the largest average decrease was observed in trauma patients (mean -0.13, SD 0.28). However, in each of the studied 22 subgroups there were survivors who reported a significant increase in QoL and survivors who reported a significant decrease in QoL.

Conclusions: This large prospective multicenter cohort study demonstrated the diversity in long-term quality of life between, and even within, subgroups of ICU survivors. These findings emphasize the need for personalized information and post-ICU care.

Trial registration: The MONITOR-IC study was registered at ClinicalTrials.gov: NCT03246334 on August 2nd 2017.

Keywords: Critical care outcomes; Patient-reported outcome measures; Prognosis; Quality of life.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart inclusion procedure
Fig. 2
Fig. 2
Percentage of patients reporting limitations in each dimension of the EQ-5D-5L, before hospital admission and 1 year after ICU admission
Fig. 3
Fig. 3
Percentage of patients experiencing an improved, unchanged or decreased quality of life 1 year after ICU admission, based on the MCID of 0.08
See this image and copyright information in PMC

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