Quality of life before and after medical intensive care

Introduction

We prospectively analysed changes in the quality of life (QOL) in patients before and 6 months after admission to a medical intensive care unit (ICU).

Patients and methods

All patients admitted to the ICU were eligible for inclusion. Patients <18 years and those who died or were discharged within 24 h of admission were excluded. QOL measures were collected during interview during the first 24 h of ICU stay and 6 months after admission using a questionnaire especially designed for ICU patients developed by the Spanish Group for Epidemiological Analysis of Critical Care Patients [1]. Baseline QOL, referred to the 2 months prior to admission and were compared with measures at 6 months using Wilcoxon matched-pairs test, P < 0.05 was considered statistically significant.

Results

During the first 12 months of the study period 326 patients met the study criteria: mean age was 58 ± 17 (± SD) years, median 60, range 19-95 years, 55% were male. Mean ICU length of stay was 10.4 ± 15.1 days, range 2-127 days. Mean APACHE II score was 23 ± 10, range 0-51. Mean TISS score after 24 h was 33 ± 14, range 0-69. Mortality rates were: ICU 24%. hospital 6%, 9% within the following 6 months after hospital discharge. Up to now 147 patients completed the questionnaire after 6 months, six patients (l.8%) were lost to follow-up. Relative to baseline a significant worsening was noted in the subscale of normal daily activities (P = 0.013). No significant changes were seen in total QOL, score (P = 0.25) an the subscales of physiologic basic activities (P = 0.06) and emotional state (P = 0.09). No correlation existed between APACHE II scores and QOL (r = 033).

Conclusion

Six months after ICU treatment patients had a significant decrease in the level of their daily activities. Basic physiologic activities and emotional status are not significantly altered. 90% of the long-term survivors were living at home and all previously occupied patients were able to return to their previous profession.