[Outcome of intensive care]

Abstract

Background: The mean hospital mortality of patients after intensive therapy in Germany is about 15%, the mortality within the intensive care unit about 8%. Short-term prognosis is mainly determined by severity of disease, type of disease and patient age.

Factors in intensive care: The impact of disease severity is measured by acute physiology score systems. The significance of disease categories becomes apparent in disease states with a continuing high mortality. Age is an independent risk factor. The higher risk of older patients cannot be explained by different diagnosis, and it is not secondary to a less aggressive therapy. The same factors mainly determine long-term prognosis. The 5-year-survival rate after intensive therapy is around 60%, a 3-fold increase as compared to the general population. Dependent upon the disease category, survival curves of intensive care patients parallel survival curves of the general population 2 years after admission. Analysis of quality of life is based upon objective measurement and subjective estimation of health-related life quality in the physical, psychological, and social life domain. Patients after intensive therapy experience a moderate but significant decrease in quality of life. This is the case in global estimations of quality of life as well as in investigations of different life domains.

Conclusion: The remaining quality of life is tolerable. This is in accordance with the positive overall judgement of intensive care by patients themselves. The chief problem of intensive care remain diseases with continuing high mortality.