[Quality of life and mortality of patients in intensive care. Indices of quality of life].
BACKGROUND
At present there is no single practical standardized scale for measuring quality of life (QL). Any proposal should include the patient's physical impairment, level of independence, and subjective perception of happiness. We combined three previously published scales to define a quality of life index (QLI) that we propose as a standard quantitative instrument. The applicability and usefulness of QLI for the measurement of the level of deterioration of patients after admission to an intensive care unit (ICU) was examined. We prospectively evaluated QL before patient admission to determine if it influences mortality, as well as long-term changes in the QL and the factors conditioning te deterioration of patients released from the UCI as evaluated by QL indicators.


METHODS
To calculate QLI, we combined the Karnofsky scale, daily life activities index, and the perception of quality of life scale. The resulting percentage (QLI) was used to evaluate 536 patients after admission to the ICU and 6 and 12 months after release. QLI was compared with the severity of disease (Apache II), probability of death (MPM), diagnostic group, and socioeconomic variables.


RESULTS
Using multivariate methods, four significant variables related with mortality were identified: Apache II--MPM, duration of the stay in the unit, age, and QLI. Our analysis of long-term deterioration showed that advanced age, high QLI before admission, and the patient's diagnostic group explained the degree of deterioration.


CONCLUSIONS
QLI was a useful instrument for obtaining a quantitative estimate of the QL of critically ill patients.
Servicio de Medicina Intensiva, Corporación Sanitaria Parc Taulí Hospital General de Manresa.
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Vilar
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Castella
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Artigas
D018806:APACHE; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D001294:Attitude to Health; D003422:Critical Care / Q000523:psychology* / Q000592:standards; D006304:Health Status; D006305:Health Status Indicators; D017052:Hospital Mortality; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009730:Nursing Assessment / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results
Calidad de vida y mortalidad a largo plazo de pacientes en medicina intensiva. Indice de calidad de vida (ICV).