Quality of life 1 year after intensive care

Introduction

The aim of our study was the comparison of quality of life before admission to the ICU and 1 year after the discharge from ICU.

Methods

Quality of life was examined in patients admitted to the interdisciplinary ICU of a university hospital from January 2000 to December 2004 for more than 3 days. The EuroQoL-5D and State Trait Anxiety Inventory questionnaires were used for the evaluation of quality of life, anxiety and psychological outcome. The Wilcoxon signed-rank test and the chi-square test were used accordingly; P < 0.05 was considered statistically significant. Stepwise multiple logistic regression analysis was performed to evaluate the dependence of quality of life after the discharge on the following assessed parameters: age, severity of the state at the time of ICU admission, length of ICU and hospital stay, length of mechanical ventilation, extent of organ dysfunction during ICU stay, and previous quality of life. The study was approved by the hospital ethical committee.

Results

Questionnaires were sent by mail to 483 patients, and 194 patients answered (41.16%). One year after discharge from the ICU, 39 (20.1%) patients were less mobile, 56 (28.9%) had worse quality of self-care, 76 (39.2%) of patients complained of a lower level of normal daily activities, 87 (44.8%) of patients suffered from a higher level of pain and 58 (29.9%) of patients perceived a higher degree of anxiety. Significant elevation of anxiety for both women and men (22.3% and 19.3% respectively) was found by the State Trait Anxiety Inventory questionnaire. All of the above mentioned changes were significant (P < 0.0001). A stepwise multiple logistic regression identified age (OR = 1.03, 95% CI = 1.004 to 1.059; P = 0.025), length of stay (OR = 1.06 95% CI = 1.02 to 1.10; P = 0.008), length of mechanical ventilation (OR = 1.05, 95% CI = 1.01 to 1.09; P = 0.017), and level of pain (OR = 8.92, 95% CI = 1.14 to 69.64; P = 0.037) and anxiety (OR = 1.04, 95% CI = 1.00 to 1.08; P = 0.048) before admission to the ICU as independent predictors of worsening of quality of life 1 year after the discharge.

Conclusion

One year after the discharge from the ICU, patients suffered from deterioration in all aspects of quality of life evaluated by the questionnaires used. Quality of life 1 year after the discharge from intensive care was influenced by its previous level, by the age, by the length of stay and by the length of mechanical ventilation.