Skip to main content

Significance of preadmission quality of life for mortality in the ICU: a prospective cohort study


Assessing whether a critically ill patient should be admitted to an ICU remains difficult and mortality amongst ICU patients is high. To render intensive care with no prospect of success is an immense emotional burden for both patient and relatives, and a great socioeconomic burden for society as well. Therefore, validated strategies that can help identify patients who will benefit from intensive care are in demand. This study seeks to investigate whether preadmission quality of life can act as a predictor of mortality amongst patients admitted to the ICU.


All patients (>18 years) admitted to the ICU for more than 24 hours are included. In order to assess preadmission quality of life, the patient or close relatives complete the Short-Form 36 (SF-36) within 72 hours after ICU admission. Mortality is evaluated from ICU admission until 30 days hereafter. Logistic regression and receiver operating characteristic analyses are employed to assess predictive value for mortality using five models: SF-36 Physical Component Summary (PCS) and APACHE II (model A), SF-36 PCS (model B), SF-36 General Health (GH) and APACHE II (model C), SF-36 GH (model D), and APACHE II (model E). Classification tables are composed in order to assess sensitivity, specificity, positive and negative predictive values and likelihood ratios.


Preliminary results, based upon data from 175 included patients, reveal an ICU mortality of 12.6% and 30-day mortality of 22.9%. No patients were lost to follow-up. When the Physical Component of SF-36 (PCS) was used as an estimate of preadmission quality of life, the area under the curve for model B (AUC = 0.80) was comparable with model E (AUC = 0.81), and better than model A (AUC = 0.85). The General Health item of SF-36 (GH), used as an estimate of preadmission quality of life, gave an AUC = 0.76 (model D). All models were controlled for sex and age.


Preliminary results indicate that the SF-36 GH and the SF-36 PCS are as good as APACHE II to predict mortality 30 days after ICU admission. However, in order to conclude whether preadmission quality of life can contribute to triage, by successfully identifying patients suitable for intensive care, final analyses, due in 2013, are awaited. These results will clarify whether future randomized controlled trials, in which preadmission quality of life acts as a supplement to triage, are justifiable.

Author information



Corresponding author

Correspondence to RB Bukan.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Bukan, R., Moeller, A., Henning, M. et al. Significance of preadmission quality of life for mortality in the ICU: a prospective cohort study. Crit Care 17, P481 (2013).

Download citation


  • General Health
  • Prospective Cohort Study
  • Characteristic Analysis
  • Physical Component Summary
  • Included Patient