Anne Kaarlola1, Ville Pettilä, Pertti Kekki. 1. Department of Anaesthesia and Intensive Care Medicine, Meilahti Hospital, Helsinki University Central Hospital, P.O. Box 340, 00029 HUS, Helsinki, Finland. anne.kaarlola@hus.fi
Abstract
OBJECTIVE: To assess the degree of change in long-term quality of life (QOL) in critically ill patients 1 and 6 years after discharge from the intensive care unit (ICU). DESIGN: Prospective observational study. SETTING: A ten-bed medical-surgical ICU in a tertiary care hospital. PATIENTS: Of the 591 consecutive patients admitted in 1995 the study comprised those 169 who responded to both QOL questionnaires, sent in 1996 and 2001. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A generic scale assessing health-related QOL, the RAND 36, sent by mail. Six years after discharge 9% of the patients considered their present health status as excellent, 37% as good, 45% as satisfactory and 9% as poor. The absolute values of the different QOL domains revealed worse physical functioning ( p<0.001), pain ( p=0.008) and general health ( p=0.012), but less emotional role limitation ( p=0.006) as compared with the 1996 values. Compared with the age- and gender-matched general population (controls), a marked improvement was detected in physical and emotional role limitations, and in vitality. However, 6 years after ICU discharge pain was worse, and physical functioning and general health were still reduced as compared with controls. CONCLUSIONS: When evaluating the long-term outcome of ICU patients, the timing of QOL assessment is essential; especially the emotional domains seem to improve slowly. Further studies focusing on the effect of time on various QOL domains and the predictive factors for a long-term QOL are therefore warranted.
OBJECTIVE: To assess the degree of change in long-term quality of life (QOL) in critically illpatients 1 and 6 years after discharge from the intensive care unit (ICU). DESIGN: Prospective observational study. SETTING: A ten-bed medical-surgical ICU in a tertiary care hospital. PATIENTS: Of the 591 consecutive patients admitted in 1995 the study comprised those 169 who responded to both QOL questionnaires, sent in 1996 and 2001. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: A generic scale assessing health-related QOL, the RAND 36, sent by mail. Six years after discharge 9% of the patients considered their present health status as excellent, 37% as good, 45% as satisfactory and 9% as poor. The absolute values of the different QOL domains revealed worse physical functioning ( p<0.001), pain ( p=0.008) and general health ( p=0.012), but less emotional role limitation ( p=0.006) as compared with the 1996 values. Compared with the age- and gender-matched general population (controls), a marked improvement was detected in physical and emotional role limitations, and in vitality. However, 6 years after ICU discharge pain was worse, and physical functioning and general health were still reduced as compared with controls. CONCLUSIONS: When evaluating the long-term outcome of ICU patients, the timing of QOL assessment is essential; especially the emotional domains seem to improve slowly. Further studies focusing on the effect of time on various QOL domains and the predictive factors for a long-term QOL are therefore warranted.
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