Evaluation of patient-perceived health status using the Medical Outcomes Survey Short-Form 36 in an intensive care unit population.
OBJECTIVE
Baseline patient functional status as assessed by providers is correlated with mortality after intensive care unit (ICU) admission. We wanted to see if patient self-perception of health status before admission to an ICU correlated with functional outcome.


METHODS
Prospective survey on a convenience sample.


METHODS
Single urban university-affiliated Veterans Affairs Medial Center.


METHODS
One hundred ninety-nine patients in surgical and medical/coronary ICUs.


METHODS
None.


METHODS
Patient-assessed baseline health status was monitored with the Medical Outcome Survey Short-Form 36 (SF-36), consisting of 36 questions that evaluate eight health status concepts. In addition, baseline functional status (Zubrod scale) was determined and severity of illness (Acute Physiology and Chronic Health Evaluation [APACHE] II) data were collected. Zubrod functional status, which includes mortality, was determined 6 wks and 6 months after ICU admission, and correlation coefficients were calculated.


RESULTS
We found it feasible to collect SF-36 health status data on a 9% sample in this setting. Less than 1% of responses were completed by proxy. The SF-36 data were internally consistent, and several of its scales including general health perception and physical functioning correlated with patient Zubrod functional status (r2 = .08, p < .001; r2 = .14, p < .001) at 6 wks as did vitality (r2 = .04, p < .01), social function (r2 = .03, p < .05), and physical role function (r2 = .02, p = .053), although to a lesser extent. Similar correlations were also found with 6-month functional status.


CONCLUSIONS
We conclude that use of the SF-36 is time efficient in an ICU setting and correlates with 6-wk and 6-month functional outcome. It correlates as well with functional outcome as either the baseline Zubrod functional status or the APACHE II severity of illness measurement. The five-question general health evaluation portion correlated almost as well with outcome as the more extensive 36-item questionnaire. Use of the SF-36 may define patient populations for comparison across hospitals. It may also target individuals with needs for additional posthospitalization care, including rehabilitation services or nursing home placement.
Welsh
C H
CH
Department of Medicine, Denver Veterans Affairs Medical Center, University of Colorado Health Sciences Center, USA.
Thompson
K
K
Long-Krug
S
S
D018806:APACHE; D000203:Activities of Daily Living; D001294:Attitude to Health; D003120:Colorado; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006787:Hospitals, Veterans; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D013997:Time Factors; D014481:United States; D014493:United States Department of Veterans Affairs