Relatives' evaluation in older patient's quality of life
Critical Care volume 14, Article number: 406 (2010)
We would like to congratulate Tabah and colleagues for their study concerning the quality of life (QOL) after intensive care unit (ICU) discharge in older patients . One could assume that obtaining information from the patient at ICU admission was rarely possible (due to critical illness or decreased consciousness) and that mostly family members provided responses. On the contrary, QOL 1 year after ICU discharge was evaluated directly from the patient. This change in evaluators, however, could be identified as a potential weakness. The tendency of relatives to underestimate the mental health of older patients has been observed . Scales and colleagues found agreement between acute respiratory distress syndrome survivors and their substitute decision-makers to be poor for all the domains of the Short Form-36 . Rothman and colleagues concluded that the agreement of relatives was so poor in the psychosocial aspects of patients' QOL they could not be used as reliable proxies .
Tabah and colleagues represent the highest concentration of expertise in the area of older ICU patients in France, and the authors have carried out a very interesting study. The ideal comparison would involve estimates of QOL obtained from survivors prior to ICU admission and after discharge. Unfortunately, this would only be possible in a small number of older ICU patients (those admitted following elective surgery) and this might limit the generalizability of the findings to the older population. Further investigation of QOL for older patients, prior to and following ICU admission, could compare data obtained from a unique source: family members.
intensive care unit
quality of life.
Tabah A, Philippart F, Timsit JF, Willems V, Francais A, Leplege A, Carlet J, Bruel C, Misset B, Garrouste-Orgeas M: Quality of life in patients aged 80 or over after ICU discharge. Crit Care 2010, 14: R2. 10.1186/cc8231
Yip JY, Wilber KH, Myrtle RC, Grazman DN: Comparison of older adult subject and proxy responses on the SF-36 health-related quality of life instrument. Aging Ment Health 2001, 5: 136-142. 10.1080/13607860120038357
Scales DC, Tansey CM, Matte A, Herridge MS: Difference in reported pre-morbid health-related quality of life between ARDS survivors and their substitute decision makers. Intensive Care Med 2006, 32: 1826-1831. 10.1007/s00134-006-0333-0
Rothman ML, Hedrick SC, Bulcroft KA, Hickman DH, Rubenstein LZ: The validity of proxy-generated scores as measures of patient health status. Med Care 1991, 29: 115-124. 10.1097/00005650-199102000-00004
The authors declare that they have no competing interests.
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Tourtier, JP., Nkilly, G.E. & Tazarourte, K. Relatives' evaluation in older patient's quality of life. Crit Care 14, 406 (2010). https://doi.org/10.1186/cc8880
- Intensive Care Unit
- Respiratory Distress Syndrome
- Distress Syndrome
- Acute Respiratory Distress Syndrome
- Intensive Care Unit Admission