Michael E Detsky1, Rachel Kohn2, Aaron M Delman3, Anna E Buehler3, Saida A Kent3, Isabella V Ciuffetelli3, Mark E Mikkelsen4, Alison E Turnbull5, Michael O Harhay6. 1. Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Sinai Health System, Toronto, ON, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada. Electronic address: michael.detsky@sinaihealthsystem.ca. 2. Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. 3. Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. 4. Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada; Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. 5. Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University, Baltimore, MD, United States; Division of Pulmonary and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States; Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States. 6. Palliative and Advanced Illness Research (PAIR) Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States; Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
Abstract
PURPOSE: To determine how patients perceive their quality of life (QOL) six months following critical illness and to measure clinicians' discriminative accuracy of predicting this outcome. MATERIALS AND METHODS: This prospective cohort study of intensive care unit (ICU) survivors asked patients to report their QOL strictly at six months compared to one month before their critical illness as better, the same, or worse. ICU physicians and nurses made six-month QOL predictions for these patients. RESULTS: Of 162 critical illness survivors, 33% (n = 53) of patients reported six-month QOL as better, 33% (n = 54) the same, and 34% (n = 55) worse. Abnormal cognition and inability to return to primary pastime or original place of residence (p < .05 for all) were associated with worse self-reported QOL at six months in multivariable regression. Predictions of patient perceptions of QOL at six months were pessimistic and had low discriminative accuracy for both physicians (sensitivity 56%, specificity 53%) and nurses (sensitivity 49%, specificity 57%). CONCLUSIONS: Among survivors of critical illness, one-third each reported their six-month post-ICU QOL as better, the same, or worse. Self-reported six-month QOL was associated with six-month function. ICU clinicians should use caution in predicting self-reported QOL, as discriminative accuracy was poor in this cohort.
PURPOSE: To determine how patients perceive their quality of life (QOL) six months following critical illness and to measure clinicians' discriminative accuracy of predicting this outcome. MATERIALS AND METHODS: This prospective cohort study of intensive care unit (ICU) survivors asked patients to report their QOL strictly at six months compared to one month before their critical illness as better, the same, or worse. ICU physicians and nurses made six-month QOL predictions for these patients. RESULTS: Of 162 critical illness survivors, 33% (n = 53) of patients reported six-month QOL as better, 33% (n = 54) the same, and 34% (n = 55) worse. Abnormal cognition and inability to return to primary pastime or original place of residence (p < .05 for all) were associated with worse self-reported QOL at six months in multivariable regression. Predictions of patient perceptions of QOL at six months were pessimistic and had low discriminative accuracy for both physicians (sensitivity 56%, specificity 53%) and nurses (sensitivity 49%, specificity 57%). CONCLUSIONS: Among survivors of critical illness, one-third each reported their six-month post-ICU QOL as better, the same, or worse. Self-reported six-month QOL was associated with six-month function. ICU clinicians should use caution in predicting self-reported QOL, as discriminative accuracy was poor in this cohort.
Authors: Lauren E Ferrante; Margaret A Pisani; Terrence E Murphy; Evelyne A Gahbauer; Linda S Leo-Summers; Thomas M Gill Journal: JAMA Intern Med Date: 2015-04 Impact factor: 21.873
Authors: Victor D Dinglas; Lisa Aronson Friedman; Elizabeth Colantuoni; Pedro A Mendez-Tellez; Carl B Shanholtz; Nancy D Ciesla; Peter J Pronovost; Dale M Needham Journal: Crit Care Med Date: 2017-03 Impact factor: 7.598
Authors: Jason H Maley; Isabel Brewster; Iris Mayoral; Renata Siruckova; Sarah Adams; Kelley A McGraw; Angela A Piech; Michael Detsky; Mark E Mikkelsen Journal: Ann Am Thorac Soc Date: 2016-08
Authors: Margaret S Herridge; Catherine M Tansey; Andrea Matté; George Tomlinson; Natalia Diaz-Granados; Andrew Cooper; Cameron B Guest; C David Mazer; Sangeeta Mehta; Thomas E Stewart; Paul Kudlow; Deborah Cook; Arthur S Slutsky; Angela M Cheung Journal: N Engl J Med Date: 2011-04-07 Impact factor: 91.245
Authors: K Rockwood; T W Noseworthy; R T Gibney; E Konopad; A Shustack; D Stollery; R Johnston; M Grace Journal: Crit Care Med Date: 1993-05 Impact factor: 7.598
Authors: Mohamed D Hashem; Aparna Nallagangula; Swaroopa Nalamalapu; Krishidhar Nunna; Utkarsh Nausran; Karen A Robinson; Victor D Dinglas; Dale M Needham; Michelle N Eakin Journal: Crit Care Date: 2016-10-26 Impact factor: 9.097
Authors: Tammy L Eaton; Leslie P Scheunemann; Brad W Butcher; Heidi S Donovan; Sheila Alexander; Theodore J Iwashyna Journal: Crit Care Explor Date: 2022-04-08